Key result
In patients treated with parenteral anticoagulants for acute coronary syndrome or venous thromboembolism, obesity was not associated with a significant difference in major bleeding (RR 0.90).
Why the study?
Obese individuals have been historically underrepresented in clinical trials despite a higher risk of VTE and ACS, necessitating suitable anticoagulation regimens.
Does obesity influence the safety (bleeding) and efficacy (mortality) of parenteral antithrombotic therapy in patients with ACS or VTE?
Systematic Review (n=40,939)
Does obesity influence the safety (bleeding) and efficacy (mortality) of parenteral antithrombotic therapy in patients with ACS or VTE?
Relative Risk: 0.9 (95% CI 0.77–1.04)
Absolute Event Rate: 6% vs 6.2%
p-value: p=0.14
Obesity does not significantly increase the risk of major bleeding in patients receiving parenteral anticoagulants for ACS or VTE, suggesting current dosing strategies are generally safe in this population.
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Supports similar major bleeding risk with standard parenteral anticoagulation in obese ACS/VTE patients; leaves open mortality benefit due to confounding.
Darzé et al. (2025) conducted a systematic review in Acute Coronary Syndrome or Venous Thromboembolism (n=40,939). Obesity (BMI ≥ 30 kg/m2) vs. Non-obesity (BMI < 30 kg/m2) was evaluated on Major bleeding (RR 0.90, 95% CI 0.77 to 1.04, p=0.14). In patients treated with parenteral anticoagulants for acute coronary syndrome or venous thromboembolism, obesity was not associated with a significant difference in major bleeding (RR 0.90).
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