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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

Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 2
<span class="paragraphSection">The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In addition, we discuss the timing of initiation of anticoagulation. In the second of a two-part review, we discuss the use of NOAC for stroke prevent...
Source: European Heart Journal - February 4, 2016 Category: Cardiology Source Type: research

The Atrial Fibrillation Conundrum in Dialysis Patients
Publication date: Available online 23 January 2016 Source:American Heart Journal Author(s): An S. De Vriese, Rogier Caluwé, Paolo Raggi The burden of atrial fibrillation (AF) and the risk of stroke are high in dialysis patients. The decision to use anticoagulation rests heavily on effective risk stratification. As both the pathophysiology of the disease and the response to therapy differ in dialysis, data from the general population cannot be extrapolated. The effect of vitamin K antagonists (VKA) on the risk of stroke in dialysis patients with AF has not been studied in randomized trials. The available observational...
Source: American Heart Journal - January 25, 2016 Category: Cardiology Source Type: research

Variability In NOAC Dose Adjustment In Atrial Fibrillation Patients With Renal Dysfunction: The Influence Of Renal Function Estimation Formulae
Conclusion MDRD and CKD-EPI eGFR fails to correctly identify a significant proportion of patients that require NOAC dose adjustment, limiting their clinical utility. Cockcroft-Gault eCrCl should be calculated for all patients in whom a NOAC is being prescribed. Teaser While glomerular filtration rate is the most common estimates of renal function employed in practice the landmark stroke prevention trials use of the Cockcroft-Gault creatinine clearance equation to determine drug eligibility and dose adjustment. In a large cohort of patients with non-dialysis dependent chronic kidney disease and atrial fibrillation the use o...
Source: Canadian Journal of Cardiology - April 26, 2018 Category: Cardiology Source Type: research

Anticoagulation in Patients with Advanced Chronic Kidney Disease: Walking the Fine Line between Benefit and Harm
Publication date: Available online 11 July 2019Source: Canadian Journal of CardiologyAuthor(s): Januvi Jegatheswaran, Gregory L. Hundemer, David Massicotte-Azarniouch, Manish M. SoodAbstractChronic kidney disease affects over 3 million Canadians and is highly associated with cardiovascular diseases that require anticoagulation, such as atrial fibrillation and venous thromboembolism. Patients with chronic kidney disease are at a problematic crossroads; they are at high risk of both thrombotic conditions requiring anticoagulation and bleeding complications due to anticoagulation. The limited high-quality clinical evidence to...
Source: Canadian Journal of Cardiology - July 12, 2019 Category: Cardiology Source Type: research

Mediacalcosis in hemodialysis, predictors and prognosis
ConclusionMediacalcosis is a severe complication since it increases the risk of cardiovascular morbidity and mortality in hemodialysis patients, to this end, the individualization of entangled factors involved in its pathophysiology, will slow down or prevent its progression in the future.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology Source Type: research

Variability in Non–Vitamin K Antagonist Oral Anticoagulants Dose Adjustment in Atrial Fibrillation Patients With Renal Dysfunction: The Influence of Renal Function Estimation Formulae
ConclusionsMDRD and CKD-EPI eGFR fail to correctly identify a significant proportion of patients who require NOAC dose adjustment, limiting their clinical utility. Cockcroft-Gault eCrCl should be calculated for all patients in whom a NOAC is being prescribed.RésuméContexteL’administration d’un nouvel anticoagulant oral non-antivitamine K (NACO) nécessite un ajustement de la dose en fonction des paramètres rénaux. La mesure de la fonction rénale la plus communément utilisée est le taux de filtration glomérulaire estimé (TFGe) selon la formule « Modified Diet in Renal Disease » (TFGe MDRD) ou « Chronic Kidne...
Source: Canadian Journal of Cardiology - July 24, 2018 Category: Cardiology Source Type: research

Anticoagulation in special patient populations with atrial fibrillation
Herz. 2021 Jul 5. doi: 10.1007/s00059-021-05042-1. Online ahead of print.ABSTRACTAnticoagulation in patients with atrial fibrillation (AF) should be guided by considerations of the risk of thromboembolism, stroke, and bleeding as well as the patient's preference. Well-recognized scores have been developed to help the clinician in daily risk assessment, but there are several special patient populations for whom scores are not developed or validated. Furthermore, these patients were not adequately represented in the pivotal randomized trials for non-vitamin K antagonist oral anticoagulants (NOACs). In patients with cancer, t...
Source: Herz - July 5, 2021 Category: Cardiology Authors: Laura Ueberham Gerhard Hindricks Source Type: research