Clinical influence of oral anticoagulants in patients with hemodialysis complicated by atrial fibrillation:a Meta-analysis
Lu You
Meng Chang
Zhang Qingjun
Gu Feifei
Miao Guobin
Abstract：Objective To systematically analyze the effectiveness and safety of oral anticoagulants in patients with hemodialysis complicated by atrial fibrillation(AF).Methods As of July 6,2023,the databases of PubMed,The Cochrane Library and EMbase were retrieved for collecting the literature about the clinical influence of oral anticoagulants(OAC)-vitamin K antagonists(VKA)and non-vitamin K antagonist oral anticoagulants(NOAC)in patients with long-term hemodialysis complicated by AF.Results There were totally 6 trials collected,including 3 randomized controlled trials(RCT)and 3 retrospective studies involved 1332 patients.The results of Meta-analysis showed that there was a statistical difference in major bleeding events between NOAC group and VKA group[RR=0.46,95%CI:0.29～0.74,I2=40%,(P=0.001)],but results of prospective studies in subgroup analysis,there was no statistical difference[RR=0.82,95%CI:0.47～1.43,I2=0%,(P=0.48)].There were no statistical differences in ischemic stroke,all-cause mortality and sudden cardiac death between 2 groups.Conclusion This Meta-analysis shows that in patients with long-term hemodialysis complicated by atrial fibrillation,the risks of thromboembolism and death associated with the use of VKA and NOAC are basically consistent.The retrospective studies seem to indicate that VKA are correlated to a higher risk of bleeding.In the future,larger-sample clinical trials will be needed to verify the selection of anticoagulants for this group of patients.
Keywords：HemodialysisAtrial fibrillationNon-vitamin K antagonists oral anticoagulantsVitamin K antagonists
Publication Date：2025-09-20
Online Publishing Date：2025-11-04(First online date of this platform, not the publication date of the document)
Pages：4( 1061-1063,1072 )