Evidence map›Paper›PMID 24113782›Full record

ArticleClinical and experimental nephrology2014

Association between warfarin use and incidence of ischemic stroke in Japanese hemodialysis patients with chronic sustained atrial fibrillation: a prospective cohort study.

Minako Wakasugi, Junichiro James Kazama, Akihide Tokumoto, Kensuke Suzuki, Shinji Kageyama, Kaoru Ohya, Yoshiaki Miura, Mamoru Kawachi, Takuma Takata, Masaaki Nagai and 6 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Clinical and experimental nephrology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 8 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 8 syntheses or guidelines pooled it, 63 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 1 country.

Minako WakasugiCenter for Inter-organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1-757, Chuo-ku, Niigata, 951-8510, Japan, minakowa@med.niigata-u.ac.jp.
Junichiro James Kazama
Akihide Tokumoto
Kensuke Suzuki
Shinji Kageyama
Kaoru Ohya
Yoshiaki Miura
Mamoru Kawachi
Takuma Takata
Masaaki Nagai
Minoru Ohya
Keiko Kutsuwada
Hideo Okajima
Isei Ei
Sachio Takahashi
Ichiei Narita
Kaetsu University · JPNiigata University · JPKensei Hospital · JPNiigata University Medical and Dental Hospital · JPShinrakuen Hospital · JPTochigi Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough generally recommended for atrial fibrillation (AF) in the general population, the efficacy and safety of warfarin in hemodialysis patients remains controversial. Warfarin use in hemodialysis patients may confer an additional risk of bleeding that is not appreciated in patients without renal failure because hemodialysis patients have platelet defects and receive anticoagulation agents during dialysis. The incidence of major bleeding was reported to be higher in Japanese AF patients on warfarin therapy compared to patients in other countries, suggesting that racial differences may influence bleeding tendency. Thus, examining risks and benefits of warfarin therapy in Japanese hemodialysis patients with AF is important.

methodsIn order to determine associations between warfarin use and new ischemic stroke events, major bleeding, and all-cause mortality, a prospective cohort study of 60 Japanese hemodialysis patients with chronic sustained AF was conducted using Cox proportional modeling and propensity score matching.

resultsThe mean patient age was 68.1 years. During 110 person-years of follow-up, 13 ischemic strokes occurred. After adjusting for CHADS2 score, warfarin use was not associated with a significant reduction in ischemic stroke events [hazard ratio (HR) 3.36; 95 % confidence interval (CI) 0.94-11.23]. Similar results were obtained after propensity score matching (HR 3.36; 95 % CI 0.67-16.66). Warfarin use was not associated with significant increases in major bleeding or all-cause mortality.

conclusionsThese results suggest that warfarin may not prevent ischemic stroke in Japanese hemodialysis patients with chronic sustained AF. Adequately powered studies are needed to determine the risks and benefits of anticoagulation therapy in these patients.

Indexed as

Renal DialysisAgedAnticoagulantsAsian PeopleAtrial FibrillationBrain IschemiaChronic DiseaseFemaleHemorrhageHumansIncidenceJapanKaplan-Meier EstimateKidney Failure, ChronicMaleMiddle AgedAnticoagulantsWarfarin

Identifiers

PMID24113782
OpenAlexW1978137598

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.