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Dialysis patients with atrial fibrillation (AF) have an elevated risk for stroke. Randomized, controlled trials (RCTs) have shown that anticoagulation reduces stroke risk in patients with AF, but no such evidence exists in those undergoing dialysis. Because dialysis patients were excluded from RCTs of novel anticoagulants, warfarin is the only anticoagulant available to them.
To examine the effects of warfarin in AF patients on dialysis, researchers conducted a population-based, retrospective study in a cohort of 205,836 patients hospitalized with AF in Canada. Of 1626 patients who were on dialysis, 46% were prescribed warfarin within 30 days after hospital discharge; compared with nonrecipients, these warfarin recipients were more likely to…