Efficacy and safety of anticoagulant therapy with warfarin in hemodialysis patients with atrial fibrillation / 中华全科医师杂志

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 groupsin 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.