BACKGROUND: The reported incidence, prevalence and outcomes of atrial fibrillation (AF) in patients with end-stage renal disease (ESRD) are variable. The risks and benefits of warfarin anticoagulation need to be defined as the risk of bleeding in ESRD patients may overwhelm the benefits of embolic stroke prevention. We undertook a systematic literature review to clarify these issues. METHODS: A literature search was undertaken using Medline and EMBASE from 1990 to September 2011. Studies that reported incidence, prevalence or selected outcomes in ESRD patients with AF were included. Cross-sectional, cohort and randomized controlled trials with >25 participants were included. The lists of authors and abstracts from the search were reviewed by two investigators to determine the manuscripts for full text review. Data were abstracted to a form designed specifically for this study. The quality of the studies was assessed using the Newcastle-Ottawa scale. Event rates were calculated using a random-effects model. RESULTS: Twenty-five studies met our inclusion criteria. The prevalence of AF was 11.6% and the overall incidence was 2.7/100 patient-years. The risk of mortality and stroke was increased in ESRD patients with AF at 26.9 and 5.2/100 patient-years versus 13.4 and 1.9/100 patient-years compared with ESRD patients without AF. The majority of studies do not support a protective effect for warfarin in ESRD patients with AF. CONCLUSIONS: The incidence and prevalence of AF in ESRD patients are higher than in the general population and are associated with an increased risk of stroke and mortality. An appropriately designed randomized controlled trial is required to determine whether anticoagulation is an appropriate therapeutic strategy in patients with end-stage renal disease and atrial fibrillation.
BACKGROUND: The reported incidence, prevalence and outcomes of atrial fibrillation (AF) in patients with end-stage renal disease (ESRD) are variable. The risks and benefits of warfarin anticoagulation need to be defined as the risk of bleeding in ESRDpatients may overwhelm the benefits of embolic stroke prevention. We undertook a systematic literature review to clarify these issues. METHODS: A literature search was undertaken using Medline and EMBASE from 1990 to September 2011. Studies that reported incidence, prevalence or selected outcomes in ESRDpatients with AF were included. Cross-sectional, cohort and randomized controlled trials with >25 participants were included. The lists of authors and abstracts from the search were reviewed by two investigators to determine the manuscripts for full text review. Data were abstracted to a form designed specifically for this study. The quality of the studies was assessed using the Newcastle-Ottawa scale. Event rates were calculated using a random-effects model. RESULTS: Twenty-five studies met our inclusion criteria. The prevalence of AF was 11.6% and the overall incidence was 2.7/100 patient-years. The risk of mortality and stroke was increased in ESRDpatients with AF at 26.9 and 5.2/100 patient-years versus 13.4 and 1.9/100 patient-years compared with ESRDpatients without AF. The majority of studies do not support a protective effect for warfarin in ESRDpatients with AF. CONCLUSIONS: The incidence and prevalence of AF in ESRDpatients are higher than in the general population and are associated with an increased risk of stroke and mortality. An appropriately designed randomized controlled trial is required to determine whether anticoagulation is an appropriate therapeutic strategy in patients with end-stage renal disease and atrial fibrillation.
Authors: Konstantinos C Siontis; Xiaosong Zhang; Ashley Eckard; Nicole Bhave; Douglas E Schaubel; Kevin He; Anca Tilea; Austin G Stack; Rajesh Balkrishnan; Xiaoxi Yao; Peter A Noseworthy; Nilay D Shah; Rajiv Saran; Brahmajee K Nallamothu Journal: Circulation Date: 2018-10-09 Impact factor: 29.690
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: An S De Vriese; Rogier Caluwé; Lotte Pyfferoen; Dirk De Bacquer; Koen De Boeck; Joost Delanote; Didier De Surgeloose; Piet Van Hoenacker; Bruno Van Vlem; Francis Verbeke Journal: J Am Soc Nephrol Date: 2019-11-08 Impact factor: 10.121
Authors: Steven M Brunelli; Dena E Cohen; Gilbert Marlowe; Daniel Liu; Levi Njord; David Van Wyck; George Aronoff Journal: J Nephrol Date: 2019-01-02 Impact factor: 3.902
Authors: Eduardo Verde; Armando Pérez de Prado; Juan M López-Gómez; Borja Quiroga; Marian Goicoechea; Ana García-Prieto; Esther Torres; Javier Reque; José Luño Journal: Clin J Am Soc Nephrol Date: 2016-10-03 Impact factor: 8.237