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A Randomized Controlled Trial Comparing Apixaban to the Vitamin K-antagonist Phenprocoumon in Patients on Chronic Hemodialysis: The AXADIA-AFNET 8 study
Conclusions: In this randomized trial comparing apixaban and VKA in patients with AF on hemodialysis with long follow-up, no differences were observed in safety or efficacy outcomes. Even on oral anticoagulation, patients with AF on hemodialysis remain at high risk of cardiovascular events. Larger randomized trials are needed to determine the optimal anticoagulation regimen for patients with AF on hemodialysis. Clinical Trial Registration: EudraCT No. 2015-005503-84, NCT02933697.PMID:36335915 | DOI:10.1161/CIRCULATIONAHA.122.062779
Source: Circulation - November 6, 2022 Category: Cardiology Authors: Holger Reinecke Christiane Engelbertz Rupert Bauersachs G ünter Breithardt Hans-Herbert Echterhoff Joachim Ger β Karl Georg Haeusler Bernd Hewing Joachim Hoyer Sabine Juergensmeyer Thomas Klingenheben Guido Knapp Lars Christian Rump Hans Schmidt-Guertle Source Type: research

Apixaban for Patients with Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial
CONCLUSIONS: There was inadequate power to draw any conclusion regarding rates of major or clinically relevant non-major bleeding comparing apixaban and warfarin in patients with AF and ESKD on hemodialysis. Clinically relevant bleeding events were approximately 10-fold more frequent than stroke or systemic embolism among this population on anticoagulation, highlighting the need for future randomized studies evaluating the risks versus benefits of anticoagulation among patients with AF and ESKD on hemodialysis.PMID:36335914 | DOI:10.1161/CIRCULATIONAHA.121.054990
Source: Circulation - November 6, 2022 Category: Cardiology Authors: Sean D Pokorney Glenn M Chertow Hussein R Al-Khalidi Dianne Gallup Pat Dignaco Kurt Mussina Nisha Bansal Crystal A Gadegbeku David A Garcia Samira Garonzik Renato D Lopes Kenneth W Mahaffey Kelly Matsuda John P Middleton Jennifer A Rymer George H Sands Ra Source Type: research

Outcomes Associated with Apixaban Use in End-Stage Kidney Disease Patients with Atrial Fibrillation in the United States.
Conclusions -Among ESKD patients with AF on dialysis, apixaban use may be associated with lower risk of major bleeding compared with warfarin, with a standard 5 mg twice a day dose also associated with reductions in thromboembolic and mortality risk. PMID: 29954737 [PubMed - as supplied by publisher]
Source: Circulation - June 28, 2018 Category: Cardiology Authors: Siontis KC, Zhang X, Eckard A, Bhave N, Schaubel DE, He K, Tilea A, Stack AG, Balkrishnan R, Yao X, Noseworthy PA, Shah ND, Saran R, Nallamothu BK Tags: Circulation Source Type: research

Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort.
CONCLUSIONS: -The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. PMID: 26680239 [PubMed - as supplied by publisher]
Source: Circulation - December 17, 2015 Category: Cardiology Authors: Shih CJ, Ou SM, Chao PW, Kuo SC, Lee YJ, Yang CY, Tarng DC, Lin CC, Huang PH, Li SY, Chen YT Tags: Circulation Source Type: research

Dabigatran and Rivaroxaban Use in Atrial Fibrillation Patients on Hemodialysis.
CONCLUSIONS: -More dialysis patients are being started on dabigatran and rivaroxaban, even when their use is contraindicated and there are no studies to support the benefits outweigh the risks of these drugs in ESRD. PMID: 25595139 [PubMed - as supplied by publisher]
Source: Circulation - January 16, 2015 Category: Cardiology Authors: Chan KE, Edelman ER, Wenger JB, Thadhani RI, Maddux FW Tags: Circulation Source Type: research

Response to letter regarding article, "warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation undergoing dialysis".
PMID: 25539527 [PubMed - in process]
Source: Circulation - December 23, 2014 Category: Cardiology Authors: Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, Humphries KH, Tu JV, Behlouli H, Guo H, Pilote L Tags: Circulation Source Type: research

Letter by qureshi et Al regarding article, "warfarin use and the risk for stroke and bleeding in patients with atrial fibrillation undergoing dialysis".
PMID: 25539526 [PubMed - in process]
Source: Circulation - December 23, 2014 Category: Cardiology Authors: Qureshi W, Alirhayim Z, Khalid F Tags: Circulation Source Type: research

Lack of Concordance between Empirical Scores and Physician Assessments of Stroke and Bleeding Risk in Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry.
CONCLUSIONS: There is little agreement between provider-assessed risk and empirical scores in AF. These differences may explain, in part, current divergence of anticoagulation treatment decisions from guideline recommendations. CLINICAL TRIAL REGISTRATION INFORMATION: clinicaltrials.gov Identifier: NCT01165710. PMID: 24682387 [PubMed - as supplied by publisher]
Source: Circulation - March 29, 2014 Category: Cardiology Authors: Steinberg BA, Kim S, Thomas L, Fonarow GC, Hylek E, Ansell J, Go AS, Chang P, Kowey P, Gersh BJ, Mahaffey KW, Singer DE, Piccini JP, Peterson ED, on behalf of the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Investigat Tags: Circulation Source Type: research

Warfarin Use and the Risk for Stroke and Bleeding in Patients with Atrial Fibrillation Undergoing Dialysis.
CONCLUSIONS: Our results suggest that warfarin use is not beneficial in reducing stroke risk but is associated with a higher bleeding risk in patients with AF undergoing dialysis. PMID: 24452752 [PubMed - as supplied by publisher]
Source: Circulation - January 22, 2014 Category: Cardiology Authors: Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, Humphries KH, Tu JV, Behlouli H, Guo H, Pilote L Tags: Circulation Source Type: research

A Pint of Sweat Will Save a Gallon of Blood: A Call for Randomized Trials of Anticoagulation in End Stage Renal Disease.
Abstract Approximately 430,000 patients were receiving maintenance dialysis in the United States in 2011(1). Compared to the general population, atrial fibrillation is far more common(2) and associated with a much higher risk of stroke in the dialysis population(3). Thus, there is an important need to define and apply strategies to reduce stroke in patients receiving dialysis with atrial fibrillation. PMID: 24452751 [PubMed - as supplied by publisher]
Source: Circulation - January 22, 2014 Category: Cardiology Authors: Granger CB, Chertow GM Tags: Circulation Source Type: research