Management of Stroke Risk in Patients on Hemodialysis with Non-Valvular Atrial Fibrillation: A Comparison of Cardiologists and Nephrologists in Canada
Antithrombotic therapy for stroke prevention in atrial fibrillation (AF) is standard practice, but for hemodialysis (HD) patients, the benefits are unclear and risks are high. Our study objectives were to compare cardiologists’ and nephrologists’ stroke prevention practices in this population and th...
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| Format: | Dissertation |
| Language: | English |
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ProQuest Dissertations & Theses
01-01-2017
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| Online Access: | Get full text |
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| Summary: | Antithrombotic therapy for stroke prevention in atrial fibrillation (AF) is standard practice, but for hemodialysis (HD) patients, the benefits are unclear and risks are high. Our study objectives were to compare cardiologists’ and nephrologists’ stroke prevention practices in this population and their associated decisional certainty. A cross-sectional, online survey was distributed to members of three Canadian physician societies (Nephrology, Cardiovascular, Heart Rhythm), and to cardiologists at three Universities. The questionnaire included four scenarios of AF in HD patients with varying stroke and bleeding risks. Respondents selected from treatment options and rated their level of certainty. Cardiologists were 3 times more likely than nephrologists to choose anticoagulant therapy, regardless of stroke or bleeding risk. Level of certainty differed between specialties across scenarios; however, this finding is not conclusive. Due to the low response rate (9%), results must be considered tentative. Physicians in Canada are encouraged to consider these differences in prescribing. |
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| ISBN: | 9780355453881 0355453886 |