Efficacy and safety analysis of warfarin in the treatment of atrial fibrillation in patients with maintenance hemodialysis:a Meta analysis
10.3760/cma.j.cn114798-20220322-00218
- VernacularTitle:华法林治疗维持性血液透析并心房颤动患者疗效及安全性的Meta分析
- Author:
Zhi LU
1
;
Bo LI
;
Haiyan PANG
;
Fang WEI
;
Lihua WANG
Author Information
1. 天津医科大学第二医院肾脏病血液净化科，天津 300211
- Keywords:
Atrial fibrillation;
Renal dialysis;
Warfarin;
Stroke
- From:
Chinese Journal of General Practitioners
2022;21(12):1157-1163
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of warfarin in the treatment of atrial fibrillation (AF) in patients with maintenance hemodialysis (MHD).Methods:Studies on evaluating efficacy and safety of warfarin in maintenance hemodialysis patients with AF were searched in CNKI, Wanfang Database of Chinese Academic Journals, PubMed, Embase and Cochrane databases from January 2001 to October 2021. The data were extracted independently by two reviewers. Meta-analysis was performed with RevMan 5.2.Results:Twelve relevant studies were included, involving 30 488 patients, 7 276 in the warfarin group and 23 212 in the control group. Meta-analysis showed that warfarin had no significant efficacy for treatment of AF in patients with maintenance hemodialysis, and there was no difference in the incidence of stroke( RR=1.10, 95%CI:0.82-1.48, P=0.52)between two groups; subgroup analysis showed that there was no significant effect on ischemic stroke or hemorrhagic stroke( RR=1.06,95% CI:0.80-1.42, P=0.67; RR=1.55,95% CI:0.93-2.58, P=0.09). There was no significant difference in mortality between the two groups( RR=1.09,95% CI:0.86-1.39, P=0.48). Meanwhile, the risk of bleeding in warfarin group was higher than that in control group( RR=1.32,95% CI:1.11-1.58, P=0.002). Conclusions:Warfarin has no significant effect on the incidence of stroke and mortality, while it increases the risk of bleeding in AF patients with maintenance hemodialysis So it is not recommended to use warfarin treatment for AF in patients with maintenance hemodialysis.
