Table 1.
Characteristics of warfarin studies in patients with end stage renal disease and atrial fibrillation
| Author Year | Setting | Study duration (years) | Study population | Study groups | Number of patients with ESRD and AF | % Female | Mean age (SD) (years) | % With stroke/TIA/TE history | % With bleeding history |
|---|---|---|---|---|---|---|---|---|---|
| Chan 2009 [30] | US, Fresenius clinics | 1.6 | Patients with incident HD, pre-existing AF | T (total) | 1671 | NR | NR | NR | NR |
| W (warfarin) | 746 | NR | NR | NR | NR | ||||
| C (no warfarin) | 925 | NR | NR | NR | NR | ||||
| Lai 2009 [32] | US, single center | 2.6 | All patients with CKD (HD and GFR < 15 mL/min/1.73 m2) and pre-existing non-valvular AF, includes prevalent warfarin users | T (total) | 245 | NR | NR | NR | NR |
| W (warfarin) | 129 | NR | NR | NR | NR | ||||
| C (no warfarin) | 96 | NR | NR | NR | NR | ||||
| Wizemann 2010 [33] | International consortium | 8 | Patients with HD who had pre-existing or newly developed AF, includes prevalent warfarin users | T (total) | 3245 | NR | NR | NR | NR |
| W (warfarin) | 509 | NR | NR | NR | NR | ||||
| C (no warfarin) | 2736 | NR | NR | NR | NR | ||||
| Winkelmayer 2011 [22] | US, New Jersey, Pennsylvania Medicare claims | 22 | All patients with incident dialysis ≥ 66 years who had first hospitalization with a primary or secondary discharge diagnosis of AF | T (total) | 2313 | NR | NR | NR | NR |
| W (warfarin) | 249 | 57.4 | 68.6 (12.1) | NR | 6.8 | ||||
| C (no warfarin) | 2064 | 57.5 | 70.1 (11.9) | NR | 16.2 | ||||
| Olesen 2012 [23] | Denmark, national registry | 12 | All patients discharged from the hospital with a diagnosis of non-valvular AF, receiving RRT | T (total) | 901 | 33.6 | 66.8 (11.7) | 14.8 | 15.2 |
| W (warfarin only) | 178 | NR | NR | NR | NR | ||||
| C (no warfarin) | 723 | NR | NR | NR | NR | ||||
| Khalid 2013 [34] | US, multi-center | 6 | Patients who were started on warfarin in the last year and re-started warfarin for atrial fibrillation after a gastrointestinal bleed | T (total) | 96 | 31.3 | 77.2 (10.6) | 52.1 | 21.2 |
| W (restarted warfarin) | 34 | NR | NR | NR | NR | ||||
| C (did not restart warfarin) | 62 | NR | NR | NR | NR | ||||
| Wakasugi 2014 [29] | Japan, multi-center | 3 | Patients aged ≥ 20 years with ESRD requiring HD and pre-existing chronic sustained AF, includes prevalent warfarin users | T (total) | 60 | NR | NR | NR | NR |
| W (warfarin) | 28 | 43 | 67.8 (9.4) | 14 | NR | ||||
| C (no warfarin) | 32 | 28 | 68.4 (8.5) | 36 | NR | ||||
| Bonde 2014 [24] | Denmark, national registry | 15 | Incident non-valvular AF discharge, receiving RRT, stratified by CHA2DS2-VASc score | T (total) | 1142 | 35.03 | 66.77 (12.03) | 16.37 | 17.51 |
| W (warfarin) | 260 | NR | NR | NR | NR | ||||
| C (no warfarin) | 882 | NR | NR | NR | NR | ||||
| Carrero 2014 [25] | Sweden, national registry | 7 | Survivors of acute myocardial infarction, history of AF or AF diagnosis in hospital, eGFR ≤ 15 ml/min/173 m2 | T (total) | 478 | NR | NR | NR | NR |
| W (warfarin) | 66 | 37.9a | 78a (NR) | 28.8a | 12.1a | ||||
| C (no warfarin) | 412 | 38.8a | 77a (NR) | 26.5a | 22.8a | ||||
| Chen 2014 [26] | Taiwan, national registry | 4.12 | Adult (≥18 years) patients with ESRD, receiving RRT, pre-existing non-valvular AF | T (total) | 3277 | NR | NR | NR | NR |
| W (warfarin) | 294 | 58.5 | NR | NR | NR | ||||
| C (no warfarin) | 2983 | 53.7 | NR | NR | NR | ||||
| Friberg 2014 [13] | Sweden, national registry | 2.1 | Any inpatient diagnosis of non-valvular AF, receiving RRT, includes prevalent warfarin users | T (total) | 13435 | 35.7 | 78.4 (10.3) | 24.6 | 30.5 |
| W (warfarin) | 3766 | NR | NR | NR | NR | ||||
| C (no warfarin) | 9669 | NR | NR | NR | NR | ||||
| Shah 2014 [27] | Canada, Quebec & Ontario regional claims | 9 | Patients aged ≥ 65 years admitted to a hospital with a primary or secondary diagnosis of AF who underwent > = 3 dialysis procedure within the 12 months preceding AF | T (total) | 1626 | NR | NR | NR | NR |
| W (warfarin) | 756 | 39 | 75.3 (8.1) | 6 | 9 | ||||
| C (no warfarin) | 870 | 39 | 75.1 (8.5) | 5 | 16 | ||||
| Genovesi 2015 [31] | Italy, multi-center | 2 | Patients with HD, pre-existing paroxysmal, persistent or permanent AF, includes prevalent warfarin users | T (total) | 290 | 40.0 | NR | 14.8 | 19.7 |
| W (warfarin) | 134 | 35.8 | NR | 15.7 | 11.9 | ||||
| C (no warfarin) | 156 | 43.6 | NR | 14.1 | 26.3 | ||||
| Chan KE 2015 [20] | US, Fresenius clinics | 4 | Patients with chronic HD, pre-existing AF | T (total) | 14607 | NR | NR | NR | NR |
| W (warfarin) | 8064 | 38.8 | 70.6 (11) | 12.7 | 3.3 | ||||
| A (aspirin) | 6018 | 42.7 | 71.7 (11) | 14.3 | 0.7 | ||||
| D (dabigatran) | 281 | 40.8 | 68.4 (12) | 12.5 | 4.1 | ||||
| R (rivaroxaban) | 244 | 39.5 | 66.9 (12) | 16.0 | 4.2 | ||||
| Chan PH 2015 [21] | China, single center | 14.5 | Patients with PD who had a diagnosis of AF treated in two hospitals, exclude HD or CKD stage 5 not on RRT, includes prevalent warfarin users | T (total) | 271 | NR | NR | NR | NR |
| W (warfarin) | 67 | 41.8 | 69.5 (9.5) | 17.9 | 1.5 | ||||
| A (aspirin) | 86 | 41.9 | 73.0 (10.0) | 25.6 | 4.7 | ||||
| C (no antithrombotic therapy) | 118 | 38.1 | 69.4 (12.7) | 10.2 | 0.8 | ||||
| Shen 2015 [28] | US, USRDS national registry | 4 | All patients with HD who had a new diagnosis of AF based on 1 inpatient or 2 outpatient diagnosis codes | T (total) | 12284 | NR | NR | NR | NR |
| W (warfarin) | 1838 | 50.3 | 61.2 (12.4) | NR | NR | ||||
| C (no warfarin) | 10446 | 51.3 | 62.1 (13.6) | NR | NR | ||||
| Wang 2015 [14] | New Zealand, single center | 9 | Patients with ESRD commenced on long-term dialysis at a hospital who had pre-existing or developed AF, includes prevalent warfarin users | T (total) | 141 | 38.3 | 61.2 (11.3) | NR | 19.1 |
| W (warfarin) | 59 | 39.0 | 59.8 (10.5) | NR | 16.9 | ||||
| C (no warfarin) | 82 | 37.8 | 62.1 (11.8) | NR | 20.7 | ||||
| Yodogawa 2015 [35] | Japan, single center | 9.5 | Patients aged ≥ 20 years with AF and ESRD requiring maintenance HD, includes prevalent warfarin users | T (total) | 84 | 30 | NR | 5 | 6 |
| W (warfarin) | 30 | 20 | 69.5 (10.7) | 10 | 3 | ||||
| C (no warfarin) | 54 | 35 | 70.4 (10.2) | 2 | 7 | ||||
| Findlay 2016 [15] | UK, single center | 7 | Adult patients receiving hemodialysis, exclude those treated for acute kidney injury, includes prevalent warfarin users | T (total) | 293 | NR | NR | NR | NR |
| W (warfarin) | 118 | NR | NR | NR | NR | ||||
| C (no warfarin) | 175 | NR | NR | NR | NR | ||||
| Tanaka 2016 [16] | Japan, multi-center | 2.5 | Patients with ESRD with dialysis initiation who became stable and were discharged from hospital with or without AF, includes prevalent warfarin users | T (total) | 93 | 37.6 | NR | NR | NR |
| W (warfarin) | 46 | 26.1 | 73.6 (8.5) | 19.6 | 6.5 | ||||
| C (no warfarin) | 47 | 34.0 | 70.7 (12.1) | 8.5 | 0.0 |
AF atrial fibrillation, HD hemodialysis, PD peritoneal dialysis, CKD chronic kidney disease, ESRD end stage renal disease, RRT renal replacement therapy, NR not reported
A all relevant patients with ESRD and AF included in study, T patients with ESRD and AF in the treatment group, C patients with ESRD and AF in the comparison group
a Data were abstracted from the online supplement