Anticoagulants in Patients with Atrial Fibrillation and End-Stage Renal Disease
Bibliographic record
Abstract
Atrial fibrillation (AF) is a common cardiac arrhythmia and is associated with an increased risk for thromboembolic stroke. Anticoagulant therapy has been shown to reduce the risk for ischemic stroke in patients with AF; however, these studies have excluded patients with end-stage renal disease (ESRD). This review examines the relationships between ESRD, AF, and the use of anticoagulants to prevent ischemic stroke. Medline and Embase were used to identify relevant articles. Identified review articles and their references were searched. The prevalence of AF in patients with ESRD is higher than that in the general population; ESRD appears to be an independent risk factor for AF. The presence of AF in patients with ESRD increases the risk for stroke, although this effect is less pronounced when compared with the general population. The presence of ESRD confers an increased risk for bleeding; warfarin appears to enhance this risk. Observational data suggest that warfarin increases the rate of hemorrhagic stroke in patients with ESRD, but are unclear on its utility in reducing ischemic stroke. In addition to increasing the risk for bleeding, warfarin may also promote vascular calcification in this population. Currently, there are no oral anticoagulants other than warfarin that are approved for use in patients with ESRD. Recent guidelines suggest that warfarin only be used for secondary prevention in patients with ESRD and AF. Randomized controlled trials are needed to clarify the role of warfarin or other anticoagulants in preventing stroke in patients with ESRD and AF.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".