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May 1, 2021Drug Design Development and TherapyOpen Access

Higher BMI (≥ 25 kg/m2) was an independent predictor for thrombosis (OR=2.094, 95% CI 1.129-3.883, P=0.019), with rivaroxaban-treated class II+ obese patients showing a significantly higher 12-month thrombosis rate versus nonobese patients (HR=6.843, P=0.001).

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Why the study?

Does BMI influence the risk of thrombosis and bleeding in nonvalvular atrial fibrillation patients treated with dabigatran or rivaroxaban?

Population

2402 DOAC anticoagulated AF patients undergoing catheter ablation

Comparison

Dabigatran vs rivaroxaban across BMI categories

Design

Retrospective cohort study

Follow-up

12 months

Authors

XLXiaoye LiCZChengchun ZuoQJQiuyi Ji

Discussion

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Overview

Obesity was associated with higher thrombosis risk on rivaroxaban; leaves open whether BMI-guided dosing is needed in obese nonvalvular AF.

Structured PICO

Does BMI influence the risk of thrombosis and bleeding in nonvalvular atrial fibrillation patients treated with dabigatran or rivaroxaban?

P
Population
2,402 patients with nonvalvular atrial fibrillation who underwent catheter ablation, treated with DOACs. Subgroups based on BMI: nonobese (n=1362, BMI < 25 kg/m2), preobese (n=521, BMI 25.0-29.9 kg/m2), class I obese (n=344, BMI 30.0-34.9 kg/m2), and class II+ obese (n=175, BMI ≥ 35.0 kg/m2).
I
Intervention
Dabigatran or rivaroxaban (including 15 mg fixed dose) across different BMI categories
C
Comparator
Comparison across BMI categories (nonobese vs preobese vs class I obese vs class II+ obese)
O
Outcome
Systemic embolism, stroke, and bleeding complications at 12 monthshard clinical

High BMI is associated with an increased risk of thromboembolic complications in atrial fibrillation patients treated with DOACs, particularly rivaroxaban, suggesting a potential need for dose adjustment in obese patients.

Cite This Study

Li et al. (2021) studied this question.

synapsesocial.com/papers/6a212fbc23521dddf4c3db9chttps://doi.org/10.2147/dddt.s303219
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