{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:29:29Z","timestamp":1785828569587,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T00:00:00Z","timestamp":1548720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Atrial fibrillation is one of the most common comorbid conditions in hemodialysis patients, and warfarin is widely prescribed anticoagulant to prevent thromboembolic complications in such patients. In the last decade, several epidemiological studies pointed out the risk of bleeding with the use of warfarin. So, this meta\u2010analysis is aimed to assess the bleeding risk associated with the use of warfarin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This meta\u2010analysis was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta\u2010analysis guidelines. PubMed, Embase, Scopus, and Cochrane central databases were searched from inception to June 10, 2018. The primary outcome was to quantify the bleeding risk associated with warfarin use. The secondary outcome was to assess the bleeding risk based on different subgroups. Review Manager (RevMan) version 5.3 was used for performing statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 15 studies, constituting a pooled sample of 53\u00a0581 patients (37.14% female), were included. Of these, 17\u00a0469 were warfarin users. We found that warfarin use had a significant association with the bleeding risk. The pooled relative risk (RR) of bleeding was estimated to be 1.35 (95% CI: 1.18\u20131.53, <jats:italic>P<\/jats:italic>\u00a0=\u00a0&lt;\u00a00.00001), and the pooled RR of major bleeding (five studies) was estimated to be 1.32 (95% CI: 1.07\u20131.63, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009). Subgroup analysis revealed a significant association of warfarin use with the intracranial hemorrhage\/hemorrhagic stroke (nine studies) (pooled RR: 1.43 [95% CI: 1.20\u20131.71, <jats:italic>P<\/jats:italic>\u00a0=\u00a0&lt;\u00a00.0001]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results indicate that warfarin use increases the risk of bleeding in hemodialysis patients with atrial fibrillation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14601","type":"journal-article","created":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T03:09:12Z","timestamp":1546830552000},"page":"975-984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Warfarin use increases bleeding risk in hemodialysis patients with atrial fibrillation: A meta\u2010analysis of cohort studies"],"prefix":"10.1111","volume":"34","author":[{"given":"Salman","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research Jamia Hamdard  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Nasir","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research Jamia Hamdard  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harveen","family":"Baxi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Pharmaceutical Education and Research Jamia Hamdard  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hamdard Institute of Medical Sciences and Research Jamia Hamdard  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Sarfaraj","family":"Hussain","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Misurata University  Misurata Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abul Kalam","family":"Najmi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, School of Pharmaceutical Education and Research Jamia Hamdard  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1001\/archinte.1995.00430050045005","article-title":"Prevalence, age distribution, and gender of patients with atrial fibrillation","volume":"155","author":"Freinberg W","year":"1995","journal-title":"Arch. 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