Kang Seok Hui, Kim Gui Ok, Kim Bo Yeon, Son Eun Jung, Do Jun Young
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea.
J Clin Med. 2024 Apr 20;13(8):2404. doi: 10.3390/jcm13082404.
: We evaluated the impact of warfarin use on the clinical outcomes of patients with atrial fibrillation who were undergoing hemodialysis (HD). : A retrospective analysis was conducted utilizing data from patients undergoing maintenance HD who participated in HD quality assessment programs. Patients who were assigned the diagnostic code for atrial fibrillation (n = 4829) were included and divided into two groups based on the use of warfarin: No group (no warfarin prescriptions (n = 4009)), and Warfarin group (warfarin prescriptions (n = 820)). : Cox regression analyses revealed that the hazard ratio for all-cause mortality in the Warfarin group was 1.15 ( = 0.005) in univariate analysis and 1.11 ( = 0.047) in multivariable analysis compared to that of the No group. Hemorrhagic stroke was significantly associated with warfarin use, but no significant association between the use of warfarin and ischemic stroke or cardiovascular events was observed. The subgroup results demonstrated similar trends. : Warfarin use is associated with a higher risk of all-cause mortality and hemorrhagic stroke, and has a neutral effect on ischemic stroke and cardiovascular events in patients with atrial fibrillation who are undergoing HD, compared to those who are not using warfarin.
我们评估了使用华法林对正在接受血液透析（HD）的心房颤动患者临床结局的影响。利用参与HD质量评估项目的维持性HD患者的数据进行了一项回顾性分析。被分配心房颤动诊断代码的患者（n = 4829）被纳入，并根据华法林的使用情况分为两组：无用药组（无华法林处方（n = 4009））和华法林组（有华法林处方（n = 820））。Cox回归分析显示，与无用药组相比，华法林组全因死亡率的风险比在单变量分析中为1.15（P = 0.005），在多变量分析中为1.11（P = 0.047）。出血性卒中与华法林的使用显著相关，但未观察到华法林使用与缺血性卒中或心血管事件之间存在显著关联。亚组结果显示出类似趋势。与未使用华法林的患者相比，使用华法林与正在接受HD的心房颤动患者全因死亡率和出血性卒中风险较高相关，而对缺血性卒中和心血管事件具有中性影响。
