Association Between Use of Warfarin for Atrial Fibrillation and Outcomes Among Patients With End-Stage Renal Disease

Key Points Question What is the role of warfarin in preventing ischemic strokes in patients with atrial fibrillation and end-stage renal disease? Findings This meta-analysis found that, although the current literature is only observational, warfarin use is associated with no change in the incidence of ischemic stroke but with a significantly higher risk of hemorrhagic stroke, no significant difference in the risk of major bleeding, and no change in overall mortality. Meaning The results suggest that warfarin use is associated with no benefit for ischemic stroke incidence or mortality and with a higher risk of hemorrhagic stroke in patients with atrial fibrillation and end-stage renal disease.