Warfarin, an anticoagulant that reduces the risk of stroke in the general population, might be associated with an increased risk of stroke in hemodialysis patients with atrial fibrillation. This finding raises important questions about the role of warfarin in the management of patients with atrial fibrillation who are undergoing dialysis.
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References
Fuster, V. et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation–executive summary [Portuguese]. Rev. Port. Cardiol. 26, 383–446 (2007).
Chan, K. E., Lazarus, J. M., Thadhani, R. & Hakim, R. M. Warfarin use associates with increased risk for stroke in hemodialysis patients with atrial fibrillation. J. Am. Soc. Nephrol. 20, 2223–2233 (2009).
Wiesholzer, M. et al. Incidence of stroke among chronic hemodialysis patients with nonrheumatic atrial fibrillation. Am. J. Nephrol. 21, 35–39 (2001).
Vázquez, E. et al. Influence of atrial fibrillation on the morbido-mortality of patients on hemodialysis. Am. Heart J. 140, 886–890 (2000).
Abbott, K. C., Trespalacios, F. C., Taylor, A. J. & Agodoa, L. Y. Atrial fibrillation in chronic dialysis patients in the United States: risk factors for hospitalization and mortality. BMC Nephrol. 4, 1 (2003).
Wang, Y. et al. VKORC1 haplotypes are associated with arterial vascular diseases (stroke, coronary heart disease, and aortic dissection). Circulation 113, 1615–1621 (2006).
Wanner, C. et al. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N. Engl. J. Med. 353, 238–248 (2005).
Elliott, M. J., Zimmerman, D. & Holden, R. M. Warfarin anticoagulation in hemodialysis patients: a systematic review of bleeding rates. Am. J. Kidney Dis. 50, 433–440 (2007).
van Walraven, C. et al. Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. JAMA 288, 2441–2448 (2002).
Chan, K. E., Lazarus, J. M., Thadhani, R. & Hakim, R. M. Anticoagulant and antiplatelet usage associates with mortality among hemodialysis patients. J. Am. Soc. Nephrol. 20, 872–881 (2009).
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Quinn, R., Scott-Douglas, N. Warfarin: safe in dialysis patients with atrial fibrillation?. Nat Rev Nephrol 6, 17–18 (2010). https://doi.org/10.1038/nrneph.2009.212
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DOI: https://doi.org/10.1038/nrneph.2009.212
