Počet záznamů: 1
Thromboembolic and Bleeding Risk in Obese Patients with Atrial Fibrillation according to Different Anticoagulation Strategies
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SYSNO ASEP 0531254 Druh ASEP J - Článek v odborném periodiku Zařazení RIV J - Článek v odborném periodiku Poddruh J Článek ve WOS Název Thromboembolic and Bleeding Risk in Obese Patients with Atrial Fibrillation according to Different Anticoagulation Strategies Tvůrce(i) Patti, G. (IT)
Pecen, Ladislav (UIVT-O) RID, SAI, ORCID
Manu, M. C. (DE)
Huber, K. (AT)
Rohla, M. (AT)
Renda, G. (IT)
Siller-Matula, J. M. (AT)
Ricci, F. (IT)
Kirchhof, P. (GB)
De Caterina, R. (IT)Celkový počet autorů 10 Zdroj.dok. International Journal of Cardiology. - : Elsevier - ISSN 0167-5273
Roč. 318, 1 November 2020 (2020), s. 67-73Poč.str. 7 s. Forma vydání Tištěná - P Jazyk dok. eng - angličtina Země vyd. IE - Irsko Klíč. slova Atrial fibrillation ; Body mass index ; Obesity ; Oral anticoagulant therapy ; Thromboembolic events ; Bleeding Vědní obor RIV FA - Kardiovaskulární nemoci vč. kardiochirurgie Obor OECD Cardiac and Cardiovascular systems Způsob publikování Omezený přístup Institucionální podpora UIVT-O - RVO:67985807 UT WOS 000573175100016 EID SCOPUS 85087026720 DOI 10.1016/j.ijcard.2020.06.010 Anotace 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. Pracoviště Ústav informatiky Kontakt Tereza Šírová, sirova@cs.cas.cz, Tel.: 266 053 800 Rok sběru 2021 Elektronická adresa http://dx.doi.org/10.1016/j.ijcard.2020.06.010
Počet záznamů: 1