Increased creatinine levels and low weight may increase bleeding risk in AF patients on oral coagulants

While AF risk appears to follow a linear pattern with increase in BMI, the pathophysiological basis of the obesity–AF relationship is complex and multifactorial. Indeed, various epidemiological studies have demonstrated an apparent paradox with regard to outcomes in AF patients; overweight and mildly obese patients with AF appear to have an overall better prognosis in terms of all-cause mortality compared with lean patients with AF. This is consistent with other cardiovascular diseases.

With this background, researchers undertook the present study to evaluate the impact of body weight and renal function have on major and clinically relevant nonmajor (CRNM) bleeding events and ischemic strokes in AF patients receiving a DOAC.

The present study consisted of a retrospective cohort study with adults with nonvalvular atrial fibrillation (NVAF) or atrial flutter (AFL) receiving a DOAC ≥12 months. The primary outcome was a composite of major and CRNM bleeding events. Secondary outcomes included ischemic stroke and risk factors for bleeding events.

Data analysis revealed the following facts.

· Of the 233 patients analyzed, 25 patients experienced a bleeding event. Patients who bled weighed 10 kg less (P = 0.043) than those who did not and had a higher HASBLED score (P = 0.003).

· Multivariate logistic regression identified weight (P = 0.048), serum creatinine (SCr; P = 0.027), and HASBLED score (P = 0.024) as the significant predictors for experiencing a bleed. Three patients experienced a stroke.

For full article follow the link: Whittemore H, Posen AK, Hellenbart EL, Groo V, Wenzler E, Tilton JJ. The impact of body weight and renal function on the risk of bleeding with direct oral anticoagulants. Ann. Pharmacother. 2021; doi: 10.1177/1060028021995201journals.sagepub.com/home/aop.

Primary source: Annals of Pharmacotherapy