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Cardiovascular and renal outcomes in patients with atrial fibrillation and stage 4 –5 chronic kidney disease receiving direct oral anticoagulants: a multicenter retrospective cohort study
AbstractThe role of direct oral anticoagulants (DOAC) in patients with atrial fibrillation (AF) and stage 4 –5 chronic kidney disease (CKD) is controversial. Electronic medical records from 2012 to 2021 were retrieved for patients with AF and stage 4–5 CKD receiving oral anticoagulants. Patients were separated into those receiving DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) or vitamin K ant agonists (VKA). Primary outcomes included ischemic stroke (IS), systemic thrombosis (SE), major bleeding, gastrointestinal bleeding, hemorrhagic stroke, acute myocardial infarction, cardiovascular death, and all-cause dea...
Source: Journal of Thrombosis and Thrombolysis - August 21, 2023 Category: Hematology Source Type: research

Clinical Outcomes of Prolonged Antiplatelet Therapy after Percutaneous Coronary Intervention in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis
Conclusions: Prolonged DAPT might decrease the risk of mortality, MACE, and stroke in patients with CKD without any significant difference in bleeding or revascularization. Additional studies are required to determine whether long-term DAPT could be considered for most CKD patients after PCI.Blood Purif
Source: Blood Purification - December 6, 2022 Category: Hematology Source Type: research

Vitamin K Antagonists: Beyond Bleeding
Abstract Warfarin is the most widely used oral anticoagulant in clinical use today. Indications range from prosthetic valve replacement to recurrent thromboembolic events due to antiphospholipid syndrome. In hemodialysis (HD) patients, warfarin use is even more frequent than in the nonrenal population due to increased cardiovascular comorbidities. The use of warfarin in dialysis patients with atrial fibrillation requires particular caution because side effects may outweigh the assumed benefit of reduced stroke rates. Besides increased bleeding risk, coumarins exert side effects which are not in the focus of clinical routin...
Source: Seminars In Dialysis - January 9, 2014 Category: Hematology Authors: Thilo Krüger, Jürgen Floege Tags: Review Source Type: research

Clopidogrel Use in End‐Stage Kidney Disease
In conclusion, current evidence suggests that ESKD patients may not derive the same benefits from clopidogrel therapy as the general population and this therapy may be associated with harm. Properly designed observational studies and randomized controlled trials are needed to establish the role of clopidogrel in patients with ESKD, the use of platelet assays to tailor therapy, and the role of other antiplatelet agents such as prasugrel or ticagrelor in patients who exhibit high on‐treatment residual platelet reactivity.
Source: Seminars In Dialysis - November 1, 2014 Category: Hematology Authors: Bassem Y. Tanios, Houssam S. Itani, Deborah L. Zimmerman Tags: Review Source Type: research

Antithrombotic therapy in end ‐stage renal disease
Abstract The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidn...
Source: Hemodialysis International - April 1, 2017 Category: Hematology Authors: Svetha Chunduri, Jon E. Folstad, Tushar J. Vachharajani Tags: Review Article Source Type: research

Mortality due to bleeding, myocardial infarction and stroke in dialysis patients
Journal of Thrombosis and Haemostasis,Volume 0, Issue ja, -Not available-.
Source: Journal of Thrombosis and Haemostasis - July 31, 2018 Category: Hematology Authors: Gurbey Ocak , Marlies Noordzij , Maarten B. Rookmaaker , Aleix Cases , C écile Couchoud , James G. Heaf , Faiçal Jarraya , Johan De Meester , Jaap W. Groothoff , Bård E. Waldum‐Grevbo , Runolfur Palsson , Halima Resic , Césa Source Type: research

Effectiveness and safety of direct oral anticoagulants in patients with venous thromboembolism and creatinine clearance   & lt;  30 mL/min
AbstractThe few studies that compared direct oral anticoagulants (DOAC) vs. warfarin in the setting of advanced renal insufficiency have focused on patients with atrial fibrillation. The purpose of this observational, matched, cohort study of patients was to assess the effectiveness and safety of DOAC vs. warfarin for the treatment of venous thromboembolism (VTE) among patients with a creatinine clearance (CrCl)  <  30 mL/min. This observational, cohort study included patients with VTE and CrCl <  30 mL/min who were newly initiated on a DOAC or warfarin between January 1, 2016 and December 31, 2020. DOAC pati...
Source: Journal of Thrombosis and Thrombolysis - December 23, 2022 Category: Hematology Source Type: research