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
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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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