Hazards of antithrombotic therapy on hemodialysis patients with atrial fibrillation and high thromboembolic risk: A Taiwanese population-based cohort study

Yu Hsien Lai, Tsung Cheng Hsieh, Chu Lin Chou, Chiu Huang Kuo, Yu Li Lin, Chih Hsien Wang, Te Chao Fang

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2 引文 斯高帕斯(Scopus)

摘要

The benefit of antithrombotic therapy in hemodialysis (HD) patients with atrial fibrillation (AF) and high thromboembolic risk has not been proved. The purpose of this study was to examine the effects of antithrombotic therapy on HD patients with AF and high thromboembolic risk. We analysed the outcomes of 1,197 HD patients with AF having CHA2DS2-VASc scores ≥ 2 points by using data retrieved from the National Health Insurance Research Database between 1997 and 2008. Four groups of patients, namely aspirin, warfarin, aspirin combined with warfarin, and non-treatment groups, were compared. Between the treatment and non-treatment groups, multivariate Cox proportional analysis revealed no significant difference in the mortality. Among the treatment groups, the aspirin combined with warfarin group had a higher mortality than that of the aspirin group. No significant differences were observed among the four groups in the risks of haemorrhagic stroke, gastrointestinal bleeding, congestive heart failure, acute coronary syndrome, and peripheral arterial occlusive disease. However, the risk of ischemic stroke was significantly higher in the aspirin and the aspirin combined with warfarin groups than in the non-treatment group. In HD patients with AF and with high thromboembolic risks, the mortality rate was not significantly different between treatment groups and non-treatment group. However, the risk of ischemic stroke was significantly higher in aspirin and aspirin plus warfarin groups when compared with non-treatment group. Therefore, the usage of aspirin and warfarin in these patients should be meticulously evaluated.
原文英語
文章編號IJCEM0053331
頁(從 - 到)13982-13991
頁數10
期刊International Journal of Clinical and Experimental Medicine
10
發行號9
出版狀態已發佈 - 九月 30 2017

ASJC Scopus subject areas

  • 生物化學、遺傳與分子生物學 (全部)

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