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Condition: Atrial Fibrillation
Therapy: Dialysis

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Total 241 results found since Jan 2013.

Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research

Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established, and in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1,2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation, possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors and to the increased...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Tags: Editorial Commentary Source Type: research

Editorial Commentary: Anticoagulation for atrial fibrillation in dialysis patients: What is known and what does the future hold?
The association between atrial fibrillation and stroke is well established and, in the general population, anticoagulation with warfarin can reduce the incidence of stroke by 60% with an acceptable bleeding risk.1, 2 Patients who are on hemodialysis have an increased prevalence of atrial fibrillation possibly secondary to comorbid conditions and hemodialysis itself causing dramatic swings in fluid and electrolytes and affecting cardiac dimensions.3 There are also substantially higher rates of ischemic stroke in this population attributable both to frequently co-occurring traditional stroke risk factors as well as the incre...
Source: Heart Rhythm - February 18, 2017 Category: Cardiology Authors: Timothy M. Markman, Saman Nazarian Source Type: research

End ‐stage renal disease and severe aortic stenosis: Does valve replacement improve one‐year outcomes?
ConclusionsPatients with ESRD and severe AS have a similar and higher survival with TAVR or SAVR when compared to BAV at 1‐year. These results may influence patient care decisions favoring valve replacement in AS patients with ESRD. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - February 16, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Jose F. Condado, Aneel Maini, Bradley Leshnower, Vinod Thourani, Jessica Forcillo, Chandan Devireddy, Kreton Mavromatis, Eric L. Sarin, James Stewart, Robert Guyton, Amy Simone, Patricia Keegan, Stamatios Lerakis, Peter C. Block, Vasilis Babaliaros Tags: Valvular and Structural Heart Diseases Source Type: research

Treatment of atrial fibrillation with warfarin among older adults with end stage renal disease.
CONCLUSION: Despite the unclear benefit and increased bleeding risk of warfarin treatment in patients with ESRD, 1 in 8 older adults undergoing dialysis with incident AF in the US who had high risk of bleeding used warfarin. Changes to warfarin therapy due to discontinuation were common after initiation. PMID: 28120282 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - January 23, 2017 Category: Urology & Nephrology Authors: Tan J, Bae S, Segal JB, Zhu J, Segev DL, Alexander GC, McAdams-DeMarco M Tags: J Nephrol Source Type: research

Warfarin Initiation, Atrial Fibrillation, and Kidney Function:  Comparative Effectiveness and Safety of Warfarin in Older Adults With Newly Diagnosed Atrial Fibrillation
Conclusions Among older adults with AF, warfarin therapy initiation was associated with a significantly lower 1-year risk for the composite outcome across all strata of kidney function. The risk for major bleeding associated with warfarin use was increased only among those with eGFRs of 60 to 89mL/min/1.73m2.
Source: American Journal of Kidney Diseases - December 18, 2016 Category: Urology & Nephrology Source Type: research

Antiplatelet agents in hemodialysis.
In conclusion, since CRF patients are one of the groups at highest risk for atherosclerotic events, it could be reasonable to use aspirin in HD patients. However, the bleeding risk in HD patients needs to be strongly evaluated, especially before starting dual AA treatment. PMID: 27928736 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - December 7, 2016 Category: Urology & Nephrology Authors: Migliori M, Cantaluppi V, Scatena A, Panichi V Tags: J Nephrol Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Cardiovascular and Stroke Risk in Japanese Hemodialysis Patients With Atrial Fibrillation
Abstract Atrial fibrillation is one of the most common arrhythmias in hemodialysis patients. We evaluated its clinical outcomes among hemodialysis patients with atrial fibrillation in Japan. Using data derived from the Japanese Dialysis Outcomes and Practice Patterns Study, we analyzed backgrounds and outcomes among hemodialysis patients with and without atrial fibrillation in Japan. Among 7002 hemodialysis patients, the prevalence of atrial fibrillation was 5.7% and the incidence was 0.2 per 100 patient‐years. Atrial fibrillation was independently associated with all‐cause mortality (hazard ratio, 1.32; 95% confidence...
Source: Therapeutic Apheresis and Dialysis - September 30, 2016 Category: Hematology Authors: Jumpei Hasegawa, Brian Bieber, Maria Larkina, Bruce M. Robinson, Sachiko Wakai, Tadao Akizawa, Akira Saito, Shunichi Fukuhara, Takashi Akiba Tags: Original Article Source Type: research

Patients' Characteristics Affect the Survival Benefit of Warfarin Treatment for Hemodialysis Patients with Atrial Fibrillation. A Historical Cohort Study
Background: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potentia...
Source: American Journal of Nephrology - September 6, 2016 Category: Neurology Source Type: research

Patients' Characteristics Affect the Survival Benefit of Warfarin Treatment for Hemodialysis Patients with Atrial Fibrillation. A Historical Cohort Study.
CONCLUSION: VKA may provide an early survival benefit; however, this is partially offset later during the follow-up. In addition, heterogeneous risk-benefit profiles were observed among subgroups of dialysis-dependent patients with AF, further emphasizing the complexities of tailoring stroke prevention strategies in this population. PMID: 27598317 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - September 6, 2016 Category: Urology & Nephrology Authors: Brancaccio D, Neri L, Bellocchio F, Barbieri C, Amato C, Mari F, Canaud B, Stuard S Tags: Am J Nephrol Source Type: research

Nonvitamin K Anticoagulant Agents in Patients With Advanced Chronic Kidney Disease or on Dialysis With AF
Nonvitamin K-dependent oral anticoagulant agents (NOACs) are currently recommended for patients with atrial fibrillation at risk for stroke. As a group, NOACs significantly reduce stroke, intracranial hemorrhage, and mortality, with lower to similar major bleeding rates compared with warfarin. All NOACs are dependent on the kidney for elimination, such that patients with creatinine clearance 
Source: Journal of the American College of Cardiology - June 14, 2016 Category: Cardiology Source Type: research

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.
Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemosta...
Source: Polskie Archiwum Medycyny Wewnetrznej - June 2, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Ischaemic stroke in patients with atrial fibrillation with chronic kidney disease undergoing peritoneal dialysis
Conclusion In CKD patients on PD with AF, who had similar ischaemic stroke risk as non-CKD counterparts, warfarin therapy is associated with reduction in risk of ischaemic stroke without a higher risk of ICH.
Source: Europace - May 24, 2016 Category: Cardiology Authors: Chan, P.-H., Huang, D., Yip, P.-S., Hai, J., Tse, H.-F., Chan, T.-M., Lip, G. Y. H., Lo, W.-K., Siu, C.-W. Tags: Atrial fibrillation Source Type: research

Risk factors and outcome of Stroke in renal transplant recipients
This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - May 23, 2016 Category: Transplant Surgery Authors: Mark D. Findlay, Peter C. Thomson, Rachael MacIsaac, Alan G. Jardine, Rajan K. Patel, Kathryn K. Stevens, Elaine Rutherford, Marc Clancy, Colin C. Geddes, Jesse Dawson, Patrick B. Mark Tags: Original Article Source Type: research