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Atrial fibrillation therapy and stroke prevention in hemodialysis patients

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F23%3A43926537" target="_blank" >RIV/00064173:_____/23:43926537 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11120/23:43926537

  • Result on the web

    <a href="https://journals.viamedica.pl/kardiologia_polska/article/view/98424" target="_blank" >https://journals.viamedica.pl/kardiologia_polska/article/view/98424</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.33963/v.kp.98424" target="_blank" >10.33963/v.kp.98424</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Atrial fibrillation therapy and stroke prevention in hemodialysis patients

  • Original language description

    The prevalence of atrial fibrillation (AF) in patients with chronic kidney disease (CKD), especially on hemodialysis (HD) is higher compared to the general population without CKD and reaches ~20%. The risk of ischemic stroke in CKD patients is also significantly increased. However, since the risk of bleeding is also significantly increased in CKD patients and the number of bleeding events exceeds the number of thrombotic events, there are great concerns regarding the routine use of anticoagulation in this patient population. No randomized studies were performed to compare anticoagulation with placebo in patients with advanced CKD and AF. This lack of knowledge is reflected in international guidelines which refrain from clear recommendations. The use of anticoagulation for stroke prevention in HD patients with AF should be strictly individualized for each patient. Anticoagulation for stroke prevention in HD patients with AF seems justified only in selected patients with high stroke and low bleeding risk. Reduced-dose direct oral anticoagulants (especially apixaban) may prove beneficial. In patients with high thrombotic and bleeding risk, left atrial appendage closure could be considered. In this article, the results of the most relevant observational studies with anticoagulation in CKD/HD patients with AF have been presented and discussed. Furthermore, results of randomized studies comparing vitamin K antagonists with non-vitamin K antagonists in CKD patients have been discussed in detail. Finally, ongoing randomized studies with reduced doses of apixaban, factor XI inhibitors, and left atrial appendage closure in CKD patients are mentioned. A brief summary of rhythm control strategies in AF is given.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

    <a href="/en/project/LX22NPO5104" target="_blank" >LX22NPO5104: National Institute for Research of Metabolic and Cardiovascular Diseases</a><br>

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Kardiologia Polska

  • ISSN

    0022-9032

  • e-ISSN

    1897-4279

  • Volume of the periodical

    81

  • Issue of the periodical within the volume

    12

  • Country of publishing house

    PL - POLAND

  • Number of pages

    12

  • Pages from-to

    1193-1204

  • UT code for WoS article

    001144072000001

  • EID of the result in the Scopus database

    2-s2.0-85181658649