Anticoagulation for Dialysis Patients with Atrial Fibrillation: No Benefit Seen

Randomized, controlled trials (RCTs) have associated anticoagulation with fewer embolic events in patients with atrial fibrillation (AF) and elevated risk for stroke. However, most, if not all, of these RCTs excluded patients on hemodialysis, and we mostly have only observational data on these patients. The current investigators examined clinical benefit and risk with anticoagulation in a network meta-analysis of 16 observational studies involving 71,877 long-term dialysis patients with AF.

Of the 16 studies, only 2 examined direct-acting oral anticoagulants. Compared with no anticoagulation, apixaban at either 2.5 or 5.0 mg or warfarin did not have associations with fewer embolic events (stroke, systemic thromboembolism, or both). Apixaban …