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Anticoagulation therapy

Balancing the risks of stroke and bleeding in CKD

Nature Reviews Nephrology volume 11, pages 200–202 (2015)Cite this article

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Whether anticoagulation with warfarin is safe and reduces risk of stroke in patients with atrial fibrillation and chronic kidney disease is unclear. A recent observational study shows a net clinical benefit of warfarin—without increased risk of bleeding—in this population, including in patients on dialysis.

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Figure 1: Efficacy and safety of NOACs versus warfarin in patients with moderate CKD.

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Authors and Affiliations

  1. Brigham and Women's Hospital Heart & Vascular Center, 75 Francis Street, Harvard Medical School, Boston, 02115, MA, USA

    Arman Qamar & Deepak L. Bhatt

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  1. Arman Qamar
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  2. Deepak L. Bhatt
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Correspondence to Deepak L. Bhatt.

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Competing interests

D.L.B. receives funding from Amarin, AstraZeneca, Bristol–Myers Squibb, Eisai, Ethicon, Forest Laboratories, Ischemix, Medtronic, Pfizer, Roche, Sanofi Aventis, and The Medicines Company; has performed unfunded research for FlowCo, PLx Pharma, and Takeda; is on the advisory board for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; the board of directors for the Boston VA Research Institute, Society of Cardiovascular Patient Care; Chair of the American Heart Association Get With The Guidelines Steering Committee; Member of the Data Monitoring Committees of the Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, Population Health Research Institute; has received honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Associate Editor; Section Editor, Pharmacology), Population Health Research Institute (clinical trial steering committee), Slack Publications (Chief Medical Editor, Cardiology Today's Intervention), WebMD (CME steering committees); and Clinical Cardiology (Deputy Editor). A.Q. declares no competing interests.

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Qamar, A., Bhatt, D. Balancing the risks of stroke and bleeding in CKD. Nat Rev Nephrol 11, 200–202 (2015). https://doi.org/10.1038/nrneph.2015.14

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