Low cellular fibronectin (<2.7 µg/mL) was associated with a nearly 4-fold increased risk of bleeding (HR 3.85, 95% CI 1.06-14.00) in rivaroxaban-treated atrial fibrillation patients during 49 months follow-up.
Cohort (n=185)
No
Does low cellular fibronectin increase the risk of bleeding in patients with atrial fibrillation on long-term rivaroxaban therapy?
185 consecutive patients with documented atrial fibrillation treated with rivaroxaban for at least 3 months, median age 70.0, 60.7% women. Key exclusions: acute coronary syndrome or stroke within 12 months, infection, cancer, chronic inflammatory disease, liver injury, eGFR < 30 mL/min/1.73 m2, use of corticosteroids, or detectable plasma rivaroxaban levels.
Low cellular fibronectin (cFn) levels (lowest quartile < 2.7 µg/mL) measured in fasting plasma, in patients receiving background rivaroxaban therapy.
High cellular fibronectin (cFn) levels (highest quartile > 4.5 µg/mL) measured in fasting plasma, in patients receiving background rivaroxaban therapy.
Non-major clinically relevant bleeding and major bleeding according to the International Society on Thrombosis and Haemostasis (ISTH) criteria during long-term follow-up.safety
Low plasma cellular fibronectin levels independently predict an increased risk of bleeding in patients with atrial fibrillation receiving long-term rivaroxaban therapy, potentially due to the formation of looser fibrin networks.
Effect estimate: HR 3.85 for bleeding comparing lowest cFn quartile (< 2.7 µg/mL) to highest quartile (> 4.5 µg/mL) (95% CI 95% CI 1.06-14.00)
p-value: p=0.04
Our results suggest that low cFn levels might help identify patients with AF at increased bleeding risk during long-term anticoagulation, and this association could partly be related to the formation of looser fibrin networks.
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Kinga Glądys
Jagiellonian University
Krzysztof Malinowski
Jagiellonian University
Elżbieta Paszek
Jagiellonian University
Neurologia i Neurochirurgia Polska
Jagiellonian University
John Paul II Hospital
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Glądys et al. (Wed,) conducted a cohort in Patients with atrial fibrillation on long-term rivaroxaban anticoagulation (n=185). Rivaroxaban anticoagulation vs. No comparator group (observational cohort) was evaluated on Risk of bleeding (major and non-major clinically relevant bleeding) during follow-up (HR 3.85 for bleeding comparing lowest cFn quartile (< 2.7 µg/mL) to highest quartile (> 4.5 µg/mL), 95% CI 95% CI 1.06-14.00, p=0.04). Low cellular fibronectin (<2.7 µg/mL) was associated with a nearly 4-fold increased risk of bleeding (HR 3.85, 95% CI 1.06-14.00) in rivaroxaban-treated atrial fibrillation patients during 49 months follow-up.
synapsesocial.com/papers/69abc0925af8044f7a4e954a — DOI: https://doi.org/10.5603/pjnns.109467