Related Experiment Video
Updated: Dec 10, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Predictive factors associated with bleeding in atrial fibrillation patients treated with anti-coagulant drugs using a
Kenji Momo1,2, Kana Shu-Toh1, Makiko Kaneko3
1Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Nakano-ku, Tokyo, Japan.
Insights
In younger atrial fibrillation patients, polypharmacy significantly increases bleeding risk when using anticoagulants. Healthcare providers should monitor younger patients on multiple medications for bleeding signs.
Area of Science:
- Cardiology
- Pharmacology
- Epidemiology
Background:
- Atrial fibrillation (AF) patients require anticoagulants to prevent stroke.
- Bleeding is a major complication of anticoagulant therapy.
- Identifying bleeding risk factors is crucial for patient safety.
Purpose of the Study:
- To identify risk factors for bleeding in atrial fibrillation patients treated with anticoagulants.
- To analyze the impact of polypharmacy on bleeding risk in AF patients.
- To stratify bleeding risk based on age and cerebrovascular disease history.
Main Methods:
- Retrospective cohort study using a Japanese claims database (2004-2016).
- Included 2796 AF patients with 4-month screening and 12-month observation periods.
- Logistic regression analysis was used to detect predictive factors for bleeding, stratified by cerebrovascular disease presence.
Main Results:
- Polypharmacy (≥6 drugs) was present in 29.1% of patients; 13.3% experienced bleeding.
- In younger AF patients (<60), polypharmacy was a significant predictor of bleeding (OR 1.09-1.20).
- History of bleeding predicted bleeding in both young and elderly; polypharmacy and starting warfarin predicted bleeding only in the young.
Conclusions:
- Polypharmacy is a significant bleeding risk factor in younger AF patients on anticoagulants.
- Physicians and pharmacists should monitor younger patients with predictive risk factors for early bleeding signs.
- This study highlights the need for tailored bleeding risk assessment in AF patients.
Objective:
To identify risk factors for bleeding in atrial fibrillation (AF) patients treated with anti-coagulants such as warfarin, apixaban, edoxaban, dabigatran, rivaroxaban using a large claims database.
Methods:
A claims database for 8926 AF patients from 2004 to 2016 was obtained from JMDC. Inc. We performed a retrospective cohort study in 2796 Japanese AF patients with 4-month screening and 12-month observation periods. Polypharmacy was defined as prescription of over six drugs. Logistic regression analysis was conducted after stratification based on the presence and absence of cerebrovascular diseases to detect the predictive factors for bleeding.
Results:
Polypharmacy was observed in 815 of 2796 (29.1%) patients. A total of 371 AF patients (13.3%) experienced bleeding in the 12-month observation period. Bleeding risk assessment using multiple logistic regression analysis revealed that the odds ratio for the number of co-administered drugs in the elderly (age for ≥60, ≤74) was not significant in those without and with cerebrovascular diseases (1.05 [0.99-1.12], N.S. and 1.10 [0.96-1.27], N.S.). In contrast, in the young (age for <60), the number of co-administered drugs was a significant predictive factor in those without and with cerebrovascular diseases (1.09 [1.03-1.16], p = 0.0054 and 1.20 [1.05-1.36], p = 0.0059). Other observed predictors were"history of bleeding" in young and elderly, but "polypharmacy" and "start from warfarin" were observed in only young.
Conclusion:
We determined the bleeding risk in the clinical setting using a large claims database. Physicians and pharmacists need to monitor patients for the initial bleeding signs, particularly in those with these predictive risk factors.
More Related Videos
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:29Venous Thrombosis III: Interprofessional Care
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:30Venous Thrombosis IV: Nursing Management
01:24Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.