Thromboembolic and Bleeding Risk in Obese Patients with Atrial Fibrillation according to Different Anticoagulation Strategies
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F67985807%3A_____%2F20%3A00531254" target="_blank" >RIV/67985807:_____/20:00531254 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11140/20:10417065 RIV/00669806:_____/20:10417065
Result on the web
<a href="http://dx.doi.org/10.1016/j.ijcard.2020.06.010" target="_blank" >http://dx.doi.org/10.1016/j.ijcard.2020.06.010</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.ijcard.2020.06.010" target="_blank" >10.1016/j.ijcard.2020.06.010</a>
Alternative languages
Result language
angličtina
Original language name
Thromboembolic and Bleeding Risk in Obese Patients with Atrial Fibrillation according to Different Anticoagulation Strategies
Original language description
Background: Data on the relationship between body mass index (BMI), thromboembolic events (TEE) and bleeding in patients with atrial fibrillation (AF) are controversial, and further evidence on the risk of such events in obese patients with AF receiving different anticoagulant therapies (OAC) is needed. Methods and results: We divided a total of 9330 participants from the prospective PREFER in AF and PREFER in AF PROLONGATION registries into BMI quartiles at baseline. Outcome measures were TEE and major bleeding complications at the 1-year follow-up. Without OAC, there was a ≥6-fold increase of TEE in the 4th vs other BMI quartiles (P =.019). OAC equalized the rates of TEE across different BMI strata. The occurrence of major bleeding was highest in patients with BMI in the 1st as well as in the 4th BMI quartile [OR 1.69, 95% CI 1.03–2.78, P =.039 and OR 1.86, 95% CI 1.13–3.04, P =.014 vs those in the 3rd quartile, respectively]. At propensity score-adjusted analysis, the incidence of TEE and major bleeding in obese patients receiving non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K-antagonist anticoagulants (VKAs) was similar (P ≥.34). Conclusions: Our real-world data suggest no obesity paradox for TEE in patients with AF. Obese patients are at higher risk of TEE, and here OAC dramatically reduces the risk of events. We here found a comparable clinical outcome with NOACs and VKAs in obese patients. Low body weight and obesity were also associated with bleeding, and therefore OAC with the best safety profile should be considered in this setting.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2020
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
International Journal of Cardiology
ISSN
0167-5273
e-ISSN
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Volume of the periodical
318
Issue of the periodical within the volume
1 November 2020
Country of publishing house
IE - IRELAND
Number of pages
7
Pages from-to
67-73
UT code for WoS article
000573175100016
EID of the result in the Scopus database
2-s2.0-85087026720