{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:40:30Z","timestamp":1792795230141,"version":"4.5.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"Key R and D Projects of Guangzhou Science and Technology Program","award":["2023B03J1243"],"award-info":[{"award-number":["2023B03J1243"]}]},{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82100273"],"award-info":[{"award-number":["82100273"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82370383"],"award-info":[{"award-number":["82370383"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007162","name":"Guangdong Provincial Department of Science and Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007162","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"crossref","award":["2023A1515012798"],"award-info":[{"award-number":["2023A1515012798"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"crossref","award":["2024A1515013289"],"award-info":[{"award-number":["2024A1515013289"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Young Doctor \u201cSailing\u201d Project","award":["SL2024A04J01866"],"award-info":[{"award-number":["SL2024A04J01866"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Atrial fibrillation (AF) is prevalent in dialysis-dependent patients, who face higher risks of thromboembolism and bleeding. Although vitamin K antagonists (VKAs) are commonly used for anticoagulation, the benefits of factor Xa (FXa) inhibitors over VKAs in this population are unclear. This systematic review aims to compare the efficacy and safety of VKAs and FXa inhibitors based on randomized controlled trials (RCTs). We conducted a systematic search of PubMed and Embase for RCTs comparing FXa inhibitors and VKAs up to November 2024. The primary safety outcome was major bleeding, and the primary efficacy outcome was stroke or systemic embolism (SSE). Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. This meta-analysis included 486 dialysis-dependent AF patients from 4 RCTs, with a median follow-up of 26 weeks to 1.88 years. FXa inhibitors were associated with a reduced risk of major bleeding compared to VKAs (RR\u2009=\u20090.64, 95% CI\u2009=\u20090.42\u20130.99; p\u2009=\u20090.04), but no significant difference in SSE (RR\u2009=\u20090.46, 95% CI\u2009=\u20090.20\u20131.02; p\u2009=\u20090.06). FXa inhibitors also showed a significantly lower risk of intracranial bleeding (RR\u2009=\u20090.40, 95% CI\u2009=\u20090.17\u20130.96; p\u2009=\u20090.04), but no differences in other outcomes, including gastrointestinal bleeding, hemorrhagic stroke, ischemic stroke, acute coronary syndrome, and mortality. This systematic review and meta-analysis suggest that FXa inhibitors may offer a safer alternative to VKAs for AF patients on dialysis, with a lower risk of bleeding and similar risks of stroke and mortality.<\/jats:p>","DOI":"10.1055\/a-2544-7919","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T19:07:17Z","timestamp":1740424037000},"page":"011-022","source":"Crossref","is-referenced-by-count":9,"title":["Safety and Efficacy of Factor Xa Inhibitors in Atrial Fibrillation Patients on Dialysis: Evidence from Four Randomized Controlled Trials"],"prefix":"10.1055","volume":"126","author":[{"given":"Wulamiding","family":"Kaisaier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yili","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"},{"name":"Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1038\/ki.2009.477","article-title":"Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy","volume":"77","author":"V Wizemann","year":"2010","journal-title":"Kidney Int"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/europace\/euq387","article-title":"Warfarin in haemodialysis patients with atrial fibrillation: what benefit?","volume":"12","author":"F Yang","year":"2010","journal-title":"Europace"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ahj.2016.01.010","article-title":"The atrial fibrillation conundrum in dialysis patients","volume":"174","author":"A S De Vriese","year":"2016","journal-title":"Am Heart J"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1093\/ndt\/gfab060","article-title":"Anticoagulation management in haemodialysis patients with atrial fibrillation: evidence and opinion","volume":"37","author":"A S De Vriese","year":"2022","journal-title":"Nephrol Dial Transplant"},{"issue":"36","key":"ref5","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"I C Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial 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