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논문분류	춘계학술대회 초록집
제목	Warfarin usage in patients with atrial fibrillation undergoing hemodialysis
저자	Mega Febrianora
출판정보	2023; 2023(1):
키워드
초록	Objectives: To determine the efficacy and safety of warfarin to prevent thromboembolic event in atrial fibrillation patient underwent hemodialysis Methods: The study's design was a retrospective observational cohort of end-stage renal disease patients with AF who underwent hemodialysis at a single centre in Indonesia from 2016-2019. The Cox regression model was applied to assess the effect of warfarin on the outcomes. We conducted a survival analysis by comparing Kaplan-Meier curves using the log-rank test. We also measured the time in therapeutic range (TTR) as a quality indicator of warfarin usage. Results: Among 444 hemodialysis patients, 126 patients with AF matched the inclusion and exclusion criteria, 88 patients completely followed up. Forty-four (50%) patients used warfarin. The mean age was 52.2 years, 52.3% female, mean duration of hemodialysis was 2.2 years. Eighty-eight patients completed the follow up with a mean follow-up of 11 months. We observed all-cause death in 86.4% of patients, ischemic stroke in 10.2%, and hemorrhagic stroke in 2.3% of patients. There were no significant differences between the two groups in all-cause death, ischemic stroke, and hemorrhagic stroke. Warfarin use was not associated with a lower rate for death (HR 0.782; 95% CI, 0.494-1.237, p=0.293) or ischemic stroke (HR 0.435; 95% CI, 0.103-1.846, p=0.259) or hemorrhagic stroke (HR 0.564; 95% CI, 0.034-9.386, p=0.689). None of the patients reaches TTR>65%. Conclusions: Warfarin has no association with mortality, ischemic stroke, and hemorrhagic stroke events rate in atrial fibrillation patients who underwent hemodialysis.
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