Association between body mass index and the risk of bleeding in elderly patients with non-valvular atrial fibrillation taking dabigatran:a cohort study  

作　　者：Ming-Hui LI Li-Hua HU Yu-Rong XIONG Yu YU Wei ZHOU Tao WANG Ling-Juan ZHU Xi LIU Hui-Hui BAO Xiao-Shu CHENG 

机构地区：[1]Department of Cardiovascular Medicine,the Second Affiliated Hospital of Nanchang University,Jiangxi,China [2]Center for Prevention and Treatment of Cardiovascular Diseases,the Second Affiliated Hospital of Nanchang University,Jiangxi,China [3]Center of Cardiovascular,Inner Mongolia People’s Hospital,Hohhot,Inner Mongolia,China

出　　处：《Journal of Geriatric Cardiology》2020年第4期193-201,共9页老年心脏病学杂志（英文版）

基　　金：supported by the Major New Drug Creation Program from National Science and Technology Major Project of China(2014ZX09303305).

摘　　要：Background Uncertainty remains regarding the association between body mass index(BMI)and the risk of bleeding in patients with non-valvular atrial fibrillation(NVAF).We aimed to investigate the association between BMI and the risk of bleeding in elderly NVAF patients taking dabigatran.Methods A total of 509 elderly NVAF patients,who were being treated at twelve centers in China from February 2015 to December 2017 and taking dabigatran,were analyzed.The exposure and outcome variables were BMI at baseline and bleeding events within the subsequent six months,respectively.Cox proportional hazards regression analysis was used to evaluate the association between BMI and the risk of bleeding.Moreover,the Cox proportional hazards regression with cubic spline functions and smooth curve fitting was conducted.Results During the six-month follow-up,50 participants experienced bleeding.Every 1 kg/m^2 increase in BMI was associated with a 12%increased risk of bleeding(P=0.021).Compared to those with BMI values in Tertile 1(<22.5 kg/m^2),the adjusted hazard ratio(HR)of bleeding for participants in Tertile 2(22.5–25.3 kg/m^2)and Tertile 3(>25.3 kg/m^2)were 2.71(95%CI:1.02–7.17)and 3.5(95%CI:1.21–8.70),respectively.The Ptrend-value was significant in all models.The adjusted smooth curve showed a linear association between BMI and bleeding.None of the stratified variables showed significant effect modification on the association between BMI and bleeding(Pinteraction>0.05).Conclusions BMI was significantly and positively associated with the risk of bleeding in elderly NVAF patients treated with dabigatran.

关 键 词：ATRIAL FIBRILLATION BLEEDING BODY mass index DABIGATRAN 

分 类 号：R541.75[医药卫生—心血管疾病]