Evidence map›Paper›PMID 26646256›Full record

Observational studyHeart and vessels2016

Warfarin use and incidence of stroke in Japanese hemodialysis patients with atrial fibrillation.

Kenji Yodogawa, Akiko Mii, Megumi Fukui, Yu-Ki Iwasaki, Meiso Hayashi, Tomohiro Kaneko, Yasushi Miyauchi, Shuichi Tsuruoka, Wataru Shimizu

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Heart and vessels, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 6 pooled it
–field-weighted citation impact
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

15 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  7. Review
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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

9 authors.

Kenji YodogawaDepartment of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. yodo@nms.ac.jp.
Akiko MiiDivisions of Nephrology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Megumi FukuiDivisions of Nephrology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Yu-Ki IwasakiDepartment of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Meiso HayashiDepartment of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Tomohiro KanekoDivisions of Nephrology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Yasushi MiyauchiDepartment of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Shuichi TsuruokaDivisions of Nephrology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Wataru ShimizuDepartment of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) is one of the major risk factor for ischemic stroke, and oral anticoagulation is generally indicated for prevention of stroke. However, the utility of oral anticoagulation for AF in dialysis patients remains controversial. In this single-center, retrospective, observational study, data from 1120 patients on maintenance hemodialysis were analyzed. Baseline medical data were collected from dialysis records including age, gender, the cause of end-stage renal disease, dialysis vintage, and comorbidities. We evaluated outcomes including stroke, major hemorrhage, and death. A total of 106 (11.4 %) patients had AF. After exclusion criteria were applied, 84 patients had analyzable data. Warfarin was prescribed in 30 (35.7 %) of these patients. The remaining 54 patients were classified as the non-warfarin group. CHADS2 score was not significantly different between the warfarin and non-warfarin group. During the mean 47 months of follow up, 7 strokes occurred. However, warfarin use was not associated with the risk for stroke [hazard ratio (HR) 1.07; 95 % confidence interval (CI) 0.20-5.74]. Kaplan-Meier analysis showed no statistically significant difference in the overall survival, stroke-free survival or bleeding-free survival between the warfarin and non-warfarin group. AF is common in Japanese dialysis patients. Despite a certain prevalence of oral anticoagulation, the present study demonstrated neither beneficial nor detrimental effects. A large randomized controlled trial should be considered.

Indexed as

AgedAged, 80 and overAnticoagulantsAtrial FibrillationFemaleHemorrhageHumansIncidenceJapanKaplan-Meier EstimateKidney Failure, ChronicMaleMiddle AgedProportional Hazards ModelsRenal DialysisRetrospective StudiesAnticoagulantsWarfarinAtrial fibrillationHemodialysisStrokeWarfarin

Identifiers

PMID26646256

What OpenQuestion holds

Textmetadata
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.