Key result
New-onset atrial fibrillation in hemodialysis patients increased ischemic stroke risk (aHR 1.27; 95% CI 1.13-1.43), which became insignificant when accounting for competing in-hospital death.
Why the study?
Does new-onset atrial fibrillation increase the risk of ischemic stroke and death in patients undergoing hemodialysis?
Population
Patients on hemodialysis with new-onset nonvalvular atrial fibrillation and matched subjects without…
Comparison
New-onset nonvalvular atrial fibrillation vs Propensity score-matched subjects without…
Design
Cohort
Authors
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Modest stroke risk elevation in HD patients with new AF cautions against routine OAC; leaves open need for RCTs to define net benefit.
Cohort
Yes
Does new-onset atrial fibrillation increase the risk of ischemic stroke and death in patients undergoing hemodialysis?
Hazard Ratio: 1.27 (95% CI 1.13–1.43)
In hemodialysis patients, new-onset AF is associated with increased mortality, but the apparent increase in ischemic stroke risk is attenuated when accounting for the high competing risk of death, diminishing the predictive value of the CHA2DS2-VASc score.
Shih et al. (2016) conducted a cohort in Hemodialysis with new-onset atrial fibrillation. New-onset nonvalvular atrial fibrillation vs. Matched subjects without arrhythmia was evaluated on Ischemic stroke (fatal or nonfatal) (aHR 1.27, 95% CI 1.13-1.43). New-onset atrial fibrillation in hemodialysis patients increased ischemic stroke risk (aHR 1.27; 95% CI 1.13-1.43), which became insignificant when accounting for competing in-hospital death.
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