Author + information
- Meytal Avgil Tsadok,
- Cynthia Jackevicius,
- Mark Eisenberg,
- Mitesh Shah,
- Vidal Essebag,
- Elham Rahme,
- Karin Humphries,
- Jack Tu and
- Louise Pilote
Warfarin is used as an anticoagulant to prevent stroke in patients with atrial fibrillation (AF), however it is associated with increased risk of bleeding. It is still debatable whether chronic kidney disease (CKD) patients undergoing dialysis should be treated with warfarin. We aimed to investigate the association between CKD patients on dialysis and the risk of stroke and bleeding in AF patients treated or not treated with warfarin.
We conducted a population-based cohort study of patients aged 65 years or older admitted to hospital with a diagnosis of AF, in Quebec, Canada, during 1999 to 2007. We used linkage between hospital discharge databases, physicians, and prescription drug claims. We evaluated the association between CKD patients on dialysis and stroke and bleeding events with regard to warfarin usage.
Of 83,513 AF patients, 1039 (1.2 %) were on dialysis. Dialysis patients were younger but had higher mean CHADS2 score (2.2 vs. 1.9). In multivariable Cox-regression analyses, among warfarin users, the risk of stroke in dialysis patients tended to be higher compared to patients not on dialysis (HR: 1.39 95%CI: 0.95, 2.04), however it did not reached statistical significance (Table 1). Bleeding risk was higher in dialysis patients, regardless of warfarin use.
Dialysis patients treated with warfarin tend to have higher risk of stroke compared to patients not undergoing dialysis. Further research in larger populations of dialysis patients is required.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation Mechanisms and Stroke Prevention
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1191M-48
- 2013 American College of Cardiology Foundation