Atrial fibrillation therapy and stroke prevention in hemodialysis patients

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11120/23:43926537

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Atrial fibrillation therapy and stroke prevention in hemodialysis patients

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Atrial fibrillation therapy and stroke prevention in hemodialysis patients

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/LX22NPO5104" target="_blank" >LX22NPO5104: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2023

Kód důvěrnosti údajů

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

Název periodika

Kardiologia Polska

ISSN

0022-9032

e-ISSN

1897-4279

Svazek periodika

81

Číslo periodika v rámci svazku

12

Stát vydavatele periodika

PL - Polská republika

Počet stran výsledku

12

Strana od-do

1193-1204

Kód UT WoS článku

001144072000001

EID výsledku v databázi Scopus

2-s2.0-85181658649