Obesity may predict bleeding during warfarin treatment
Adults with obesity have an elevated risk for bleeding while assigned warfarin therapy compared with adults who are normal weight, researchers reported at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease Scientific Sessions.
Researchers examined the association between BMI and bleeding in a study of 863 patients assigned warfarin who came to an anticoagulation clinic during a 1-year period. The mean age of the patients was 69 years and 44% were women. The researchers calculated CHA2DS2-VASc scores for each patient and documented major and minor bleeding events.
Patients were stratified by BMI category: normal weight (21%); overweight (38%); obese class I (21%); obese class II (9%); or obese class III (11.3%).
Adedotun A. Ogunsua, MD, from the University of Massachusetts Medical School, and colleagues documented that 8.2% of patients had a bleeding event, of which 35.2% were major and 64.8% were minor, during the study period.
In univariate analyses, the HR for major bleeding risks increased with higher obesity category (obese class I, HR = 1.3; obese class II, HR = 1.85; obese class III, HR = 1.93). In a multivariable adjusted model, obesity (BMI > 30 kg/m2) was a significant predictor of major bleeds (HR = 1.84; 95% CI, 1.33-2.55).
In other results, congestive HF also predicted major bleeds (HR = 1.78; 95% CI, 1.02-3.11) and Hispanic ethnicity was protective against bleeding (HR = 0.28; 95% CI, 0.17-0.48).
“Future studies are needed to understand the mechanism by which obesity increases bleeding risk for patients on warfarin and whether similar risk exists for the novel oral anticoagulants,” the researchers wrote in an abstract. – by Erik Swain
Reference:
Ogunsua AA, et al. Abstract 388. Presented at: Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease Scientific Sessions; May 7-9, 2015; San Francisco.
Disclosure: Ogunsua reports no relevant financial disclosures.
Source: www.healio.com
