Marco Vitolo: The Odyssey of Stroke Prevention in ESRD and AF
Marco Vitolo, Attending Cardiologist, Tenure-Track Assistant Professor – University of Modena and Reggio Emilia, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in EJIM, adding:
“With The Odyssey in cinemas these days, it is a good time to revisit our clinical insight published a few months ago in EJIM
The Odyssey of stroke prevention in ESRD individuals with AF
A long and still unfinished journey towards the best strategy for stroke prevention in patients with atrial fibrillation and end-stage renal disease.
Still looking for our Ithaca
- Vitamin K antagonists: the traditional strategy, but with major limitations and no solid randomized evidence of net clinical benefit.
- DOACs: a major evolution in anticoagulation, but with ESRD and dialysis patients largely excluded from pivotal trials.
- Randomized trials in dialysis: RENAL-AF, AXADIA-AFNET and Valkyrie, which have not yet provided a definitive answer.
- Left atrial appendage occlusion — a promising non-pharmacological route, but still awaiting robust randomized evidence in ESRD.
- Factor XI inhibitors and new strategies — potentially pointing towards a safer balance between thrombosis and bleeding.”
Title: Stroke prevention in atrial fibrillation patients with end-stage renal disease: how far from Ithaca after a long Odyssey?
Authors: Davide Antonio Meia, Francesco Trittoa, Jacopo Francesco Imbertia, Marco Vitoloa, Giuseppe Boriani
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