ArticleNephrology (Carlton, Vic.)2019
Warfarin use and the risk of stroke, bleeding, and mortality in older adults on dialysis with incident atrial fibrillation.
Article in Nephrology (Carlton, Vic.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Anticoagulation for Patients With Concomitant Atrial Fibrillation and End-Stage Renal Disease: A Systematic Review and Network Meta-Analysis.Journal of the American Heart Association · 2024Pooled it
- Anticoagulant drugs for patients with atrial fibrillation on dialysis: a systematic analysis and network meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Association Between Use of Warfarin for Atrial Fibrillation and Outcomes Among Patients With End-Stage Renal Disease: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Effect of anticoagulation therapy in older patients with chronic kidney disease and atrial fibrillation: A meta-analysis.Medicine · 2019Pooled it
- Systematic Review and Meta-Analysis of the Frequency of Thromboembolic Events, Bleeding, and Mortality in Patients with Atrial Fibrillation and End-Stage Renal Disease Undergoing Percutaneous Left Atrial Appendage Closure.Journal of clinical medicine · 2026Review
- Off-Label NOACs vs. Antiplatelets in AF-Related Stroke with GFR < 15 mL/Min/1.73 mBiomedicines · 2025Article
- Atrial Fibrillation Is Associated With Increased In-Hospital and 1-Year Mortality in Patients Receiving Hemodialysis With ST Elevation Myocardial Infarction: A Retrospective Cohort Study.Kidney medicine · 2025Article
- Generalizability of kidney transplant data in electronic health records - The Epic Cosmos database vs the Scientific Registry of Transplant Recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Oral anticoagulation for stroke prevention in atrial fibrillation and advanced kidney disease.Research and practice in thrombosis and haemostasis · 2024Article
- Risk of Stroke With Mitral Stenosis: The Underlying Mechanism, Treatment, and Prevention.Cureus · 2022Review
- Warfarin-Related Nephropathy Manifested as Diffuse Mesangial Proliferative Glomerulonephritis.Cureus · 2022Article
- Survival Benefit of Anticoagulation Therapy in End Stage Kidney Disease Patients with Atrial Fibrillation: A Single Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2021Article
- Best quality indicator of vitamin K antagonist therapy to predict mortality and bleeding in haemodialysis patients with atrial fibrillation.Blood transfusion = Trasfusione del sangue · 2021Article
- Stroke prevention strategies in high-risk patients with atrial fibrillation.Nature reviews. Cardiology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
aimThere is conflicting evidence regarding the safety and effectiveness of warfarin for atrial fibrillation (AF) treatment among older end-stage renal disease (ESRD) patients, and differences among subgroups are unclear.
methodsOlder dialysis patients who were newly diagnosed with AF (7/2007-12/2011) were identified in the United States Renal Data System. The adjusted hazard ratios (HR) of the outcomes (any stroke, ischaemic stroke, major bleeding, severe gastrointestinal bleeding, and death) by time-varying warfarin use were estimated using Cox regression accounting for the inverse probability of treatment weight.
resultsAmong 5765 older dialysis patients with incident AF, warfarin was associated with significantly increased risk of major bleeding (HR = 1.50, 95% CI 1.33-1.68), but was not statistically associated with any stroke (HR = 0.92, 95% CI 0.75-1.12), ischaemic stroke (HR = 0.88, 95%CI 0.70-1.11) or gastrointestinal bleeding (HR = 1.03, 95% CI 0.80-1.32). Warfarin use was associated with a reduced risk of mortality (HR = 0.72, 95%CI 0.65-0.80). The association between warfarin and major bleeding differed by sex (male: HR = 1.29; 95%CI 1.08-1.55; female: HR = 1.67; 95%CI 1.44-1.93; P-value for interaction = 0.03).
conclusionOlder ESRD patients with AF who were treated with warfarin had a no difference in stroke risk, lower mortality risk, but increased major bleeding risk. The bleeding risk associated with warfarin was greater among women than men. The risk/benefit ratio of warfarin may be less favourable among older women.
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