| Severe renal impairment and stroke prevention in atrial fibrillation implications for thromboprophylaxis and bleeding risk. | |
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MedLine Citation:
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PMID: 21414530 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The prevalence of atrial fibrillation (AF) in end-stage renal failure is high, with an increased risk of stroke among these patients with AF compared with the AF population without severe renal impairment. Many trials have shown the net clinical benefit of oral anticoagulation therapy for primary and secondary prevention of stroke in patient populations with AF. However, current stroke risk stratification schemes are based on studies that have deliberately excluded patients with severe renal impairment. Indeed, there are no large randomized controlled trials that assess the real risk/benefit of full intensity anticoagulation in patients with severe renal impairment. Also, rates of major bleeding episodes in anticoagulated hemodialysis patients with AF are high. These data are influenced by the lack of appropriate monitoring, the difficulties in maintaining the international normalized ratio target (variable between the studies), and an inaccurate bleeding classification. Thus, the limited available data may be difficult to apply to such a heterogeneous patient population, characterized by both an increased risk of bleeding and a hypercoagulability state, as seen in the patient population with severe renal impairment. |
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Authors:
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Ricarda Marinigh; Deirdre A Lane; Gregory Y H Lip |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1339-48 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom; University of Trieste, Cardiology Department, Cattinara Hospital, Trieste, Italy. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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