Why the study?
The rising incidence of combined atrial fibrillation and chronic kidney disease complicates stroke prevention, and the risk-benefit of anticoagulation in low-risk patients under 65 years remains unclear.
Does anticoagulation or left atrial appendage occlusion prevent stroke in male patients under 65 years with atrial fibrillation and chronic kidney disease?
Systematic Review
Does anticoagulation or left atrial appendage occlusion prevent stroke in male patients under 65 years with atrial fibrillation and chronic kidney disease?
Answers are grounded in this paper and cite their sources.
In low-risk male patients under 65 with atrial fibrillation and chronic kidney disease, LAAO may offer better stroke prevention outcomes than oral anticoagulation, though more targeted studies are needed.
Over the last few years, there has been a rising incidence of atrial fibrillation and chronic kidney disease cases. Stroke is the major complication seen in such patients. The combination of both diseases makes patient management more tedious. PubMed and Google Scholar underwent screening with keywords and a Medical Subject Heading (MeSH) combination. The words were "atrial fibrillation," "chronic kidney disease/chronic renal insufficiency," "anticoagulation," "efficacy," and "left atrial appendage occlusion." Articles had screening and appraisal. With the English language as a filter, papers from 2002 to 2022 are part of this review. We reviewed studies including male patients with atrial fibrillation and chronic kidney disease under 65 years to see their risk-benefit from anticoagulation. In addition, left atrial appendage occlusion (LAAO) is also compared. A total of eight articles are part of this systematic review. Age plays a more prominent role than gender regarding the impact of drugs on stroke prevention. LAAO also shows a better outcome than oral anticoagulation, provided people agree to undergo surgery. More studies must be done for this target population, especially comparing results with LAAO and oral anticoagulation.
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Ravi et al. (2022) conducted a systematic review in Atrial fibrillation and chronic kidney disease. Anticoagulants and Left Atrial Appendage Occlusion vs. Warfarin was evaluated on Stroke prevention (ischemic and hemorrhagic).
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