Efficacy and safety of anticoagulant therapy with warfarin in hemodialysis patients with atrial fibrillation
10.3760/cma.j.issn.1671-7368.2019.02.013
- VernacularTitle:华法林抗凝治疗终末期肾病行血液透析并心房颤动患者的临床观察
- Author:
Guangji WANG
1
;
Bin KONG
;
Yu LIU
;
He HUANG
Author Information
1. 武汉大学人民医院心内科武汉大学心血管病研究所心血管病湖北省重点实验室 430060
- Keywords:
Warfarin;
Renal dialysis;
Atrial fibrillation;
Stroke;
Hemorrhage;
Death
- From:
Chinese Journal of General Practitioners
2019;18(2):161-165
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of anticoagulant therapy with warfarin for hemodialysis patients with atrial fibrillation.Methods A cohort of 118 hemodialysis patients with atrial fibrillatio were enrolled.The patients were divided into two groups:in warfarin group (n=53) the standard medication of warfarin was given for at least 3 months by adjusting the INR between 2.0 and 3.0;while no anticoagulants were given after discharge in non-warfarin group (n=65).Patients were followed up regularly,the events of stoke,death and bleeding were documented and compared between two groups.Results There were no significant differences in age,sex,underlying disease,predictive score of stroke risk in patients with non-valvular atrial fibrillation (CHA2DS2-VASc),predictive score of bleeding risk in patients with non-valvular atrial fibrillation (HAS-BLED) and dialysis frequency between the two groups (P＞0.05).There were no significant differences in events of ischemic stroke [11％(6/53) vs.12％(8/65),x2=0.027,P=0.87],bleedings [(9％(5/53) vs.5％(3/65),P=0.46] and gastrointestinal bleeding events [6％(3/53) vs.3％ (2/65),P=0.66] between two groups.There were no significant differences in the death event [15％(10/53) vs.22％(14/65),x2=0.129,P=0.72] and cardiac death [9％(5/53) vs.11％(7/65),x2=0.057,P=0.81] between two groups.Conclusion This study suggests that warfarin may not prevent ischemic stroke in hemodialysis patients with chronic atrial fibrillation,further studies are needed to determine the risks and benefits of anticoagulation therapy in these patients.
