Recent Advances in Stroke Prevention in Patients with Atrial Fibrillation and End-Stage Renal Disease

F Ronco, P Mazzone, L Hosseinian, S Genovesi

Research output: Contribution to journalArticle

Abstract

Background: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. Summary: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA. Limited data from post hoc analyses of controlled clinical trials suggest the safe and effective use of NOACs in patients with moderate renal impairment (i.e., estimated glomerular filtration rate, eGFR, between 30 and 50 mL/min). The question still remains whether NOACs can be used in patients with an eGFR
Original languageEnglish
Pages (from-to)207-217
Number of pages11
JournalCardioRenal Medicine
Volume7
Issue number6
DOIs
Publication statusPublished - 2017

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