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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Risk factors of bleeding in patients with atrial fibrillation undergoing percutaneous coronary intervention: an
Yang Li1, Wenbin Lu1, Yu Wang1
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Insights
Alcohol consumption and older age increase bleeding risk for atrial fibrillation patients undergoing percutaneous coronary intervention (PCI). Lower body weight is also a risk factor, especially with triple therapy.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Research
Background:
- Bleeding risk associated with dual or triple therapy after percutaneous coronary intervention (PCI) in atrial fibrillation (AF) patients requires further investigation.
- The MANJUSRI trial provided data to explore these risk factors.
Purpose of the Study:
- To identify risk factors for bleeding in atrial fibrillation patients receiving dual or triple therapy post-PCI.
- To inform individualized anticoagulation management strategies.
Main Methods:
- Analysis of data from the MANJUSRI trial, comparing dual therapy (ticagrelor + warfarin) and triple therapy (clopidogrel + aspirin + warfarin).
- Multivariate regression analysis to determine significant bleeding risk factors.
Main Results:
- Overall bleeding incidence at 6 months was similar between dual (36.49%) and triple (35.62%) therapy groups (P > 0.05).
- Alcohol consumption was a significant risk factor for overall bleeding in the total cohort and the dual therapy group.
- Older age (OR=1.059) and lower body mass index (OR=0.911) were associated with increased bleeding risk in the triple therapy group.
Conclusions:
- Alcohol consumption, older age, and lower body weight are key factors increasing bleeding risk in AF patients post-PCI.
- These findings emphasize the need for individualized anticoagulation management to mitigate bleeding complications.
Background:
The risk factors of bleeding related to dual or triple therapy in patients with atrial fibrillation after percutaneous coronary intervention (PCI) are not fully explored. We addressed this issue on patients enrolled in the MANJUSRI trial.
Methods:
Data of patients assigned to the dual therapy group (ticagrelor + warfarin, Dual group) and the triple group (clopidogrel + aspirin + warfarin, Triple group) in the MANJUSRI trial were analyzed. Multivariate regression analysis was used to determine the risk factors of bleeding among enrolled patients.
Results:
The incidence of overall bleeding at 6 months was 36.49% in the dual group and 35.62% in the triple group (P > 0.05). Multivariate cox regression analysis showed that alcohol consumption was positively correlated with overall bleeding in the total cohort (OR = 3.905, P = 0.001) and in the dual therapy group (OR = 4.643, P = 0.034). Age was positively associated with overall bleeding risk (OR = 1.059, P = 0.032), while body mass index was negatively associated with overall bleeding risk (OR = 0.911, P = 0.048) in the triple therapy group.
Conclusions:
Alcohol consumption increased the risk of overall bleeding after PCI in atrial fibrillation patients, especially in patients treated with warfarin and ticagrelor. Aging also increased bleeding risk in the whole cohort. Lower body weight contributed significantly to increased risk of overall bleeding in AF patients post PCI receiving combined clopidogrel, aspirin and warfarin medications. Above factors should be considered in terms of individualized anticoagulation management in AF patients post PCI aiming to reduce their bleeding risk.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT02206815, identifier NCT02206815.
