Association of warfarin with congestive heart failure and peripheral artery occlusive disease in hemodialysis patients with atrial fibrillation

作者：Lee Kuo Hua; Li Szu Yuan; Liu Jin Sin; Huang Chi Ting; Chen Ying Ying; Lin Yao Ping; Hsu Chih Cheng; Tarng Der Cherng^*

来源：Journal of the Chinese Medical Association, 2017, 80(5): 277-282.

DOI：10.1016/j.jcma.2016.10.012

• atrial fibrillation
• hemodialysis
• warfarin

Background: The effect of warfarin on the risk of cardiovascular (CV) disease is unknown among chronic hemodialysis patients with atrial fibrillation (HD-AF).
Methods: Population-based propensity score and prescription time -distribution matched cohort study including 6719 HD-AF patients with CHA(2)DS(2)-VASc score >= 2 were divided into warfarin users and nonusers and followed-up for CV events and death.
Results: Warfarin treatment in HD-AF patients with AF preceding HD was associated with higher risks of developing congestive heart failure [hazard ratio (HR) = 1.82, 95% confidence interval (CI) = 1.29-2.58, p < 0.01], peripheral artery occlusive disease (HR = 3.42, 95% CI = 1.86-6.31, p < 0.01), and aortic valve stenosis (HR = 3.20, 95% CI = 1.02-9.98, p < 0.05). Warfarin users were not associated with risks of ischemic or hemorrhagic stroke and all-cause mortality as compared to nonusers.
Conclusion: Warfarin may be associated with vascular calcification, increasing the risks of congestive heart failure and peripheral artery occlusive disease among HD-AF patients.

• 出版日期2017-5
• 单位中国医科大学