Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study
Objective: Elevated systolic blood pressure (SBP) can significantly increase the bleeding risk in patients with atrial fibrillation (AF). However, it is unclear whether elevated diastolic blood pressure (DBP), in the presence of well-controlled SBP is also associated with bleeding. Therefore, we aim...
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KARE Publishing
2020-10-01
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| Series: | Anatolian Journal of Cardiology |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-11823 |
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| _version_ | 1850245381017829376 |
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| author | Yu Yu Minghui Li Wei Zhou Tao Wang Lingjuan Zhu Lihua Hu Huihui Bao Xiaoshu Cheng |
| author_facet | Yu Yu Minghui Li Wei Zhou Tao Wang Lingjuan Zhu Lihua Hu Huihui Bao Xiaoshu Cheng |
| author_sort | Yu Yu |
| collection | DOAJ |
| description | Objective: Elevated systolic blood pressure (SBP) can significantly increase the bleeding risk in patients with atrial fibrillation (AF). However, it is unclear whether elevated diastolic blood pressure (DBP), in the presence of well-controlled SBP is also associated with bleeding. Therefore, we aimed to examine the specific relationship between DBP and bleeding in patients with AF treated with anticoagulants and had well-controlled SBP.
Methods: We analyzed data from 542 of 929 patients with nonvalvular AF (NVAF) treated with dabigatran from the Monitor System for the Safety of Dabigatran Treatment study (MISSION-AF) who had a SBP of 120–140 mm Hg at the time of enrollment. The association between DBP and bleeding was analyzed using multivariate logistic regression and smooth curve fitting (penalized spline method). Threshold saturation effect analysis was used to show the nonlinear relationship between DBP and bleeding.
Results: After 3 months of follow-up, 49 bleeding events occurred. Compared with participants with DBP <80 mm Hg, those with DBP ≥80 mm Hg had a 118% higher bleeding risk [hazard ratio (HR): 2.18; 95% confidence interval (CI): 1.19, 3.98; p<0.05]. The smooth curve showed a nonlinear relationship between DBP and bleeding risk, and the inflection point of DBP was 80 mm Hg. When DBP was ≥80 mm Hg, the bleeding risk increased by 59% (HR: 1.59; 95% CI: 1.16, 2.19; p<0.05) for every 5 mm Hg increase in DBP.
Conclusion: Upon achieving an optimal SBP (120–140 mm Hg), a higher DBP might be associated with a higher bleeding risk in patients with NVAF treated with dabigatran. |
| format | Article |
| id | doaj-art-05babb6033f141129a2d1c0a8d5018c2 |
| institution | OA Journals |
| issn | 2149-2263 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Anatolian Journal of Cardiology |
| spelling | doaj-art-05babb6033f141129a2d1c0a8d5018c22025-08-20T01:59:30ZengKARE PublishingAnatolian Journal of Cardiology2149-22632020-10-0124426727310.14744/AnatolJCardiol.2020.11823AJC-11823Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world studyYu Yu0Minghui Li1Wei Zhou2Tao Wang3Lingjuan Zhu4Lihua Hu5Huihui Bao6Xiaoshu Cheng7Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaCenter for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaCenter for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaCenter for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaCenter for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaCenter for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University; Jiangxi-ChinaObjective: Elevated systolic blood pressure (SBP) can significantly increase the bleeding risk in patients with atrial fibrillation (AF). However, it is unclear whether elevated diastolic blood pressure (DBP), in the presence of well-controlled SBP is also associated with bleeding. Therefore, we aimed to examine the specific relationship between DBP and bleeding in patients with AF treated with anticoagulants and had well-controlled SBP. Methods: We analyzed data from 542 of 929 patients with nonvalvular AF (NVAF) treated with dabigatran from the Monitor System for the Safety of Dabigatran Treatment study (MISSION-AF) who had a SBP of 120–140 mm Hg at the time of enrollment. The association between DBP and bleeding was analyzed using multivariate logistic regression and smooth curve fitting (penalized spline method). Threshold saturation effect analysis was used to show the nonlinear relationship between DBP and bleeding. Results: After 3 months of follow-up, 49 bleeding events occurred. Compared with participants with DBP <80 mm Hg, those with DBP ≥80 mm Hg had a 118% higher bleeding risk [hazard ratio (HR): 2.18; 95% confidence interval (CI): 1.19, 3.98; p<0.05]. The smooth curve showed a nonlinear relationship between DBP and bleeding risk, and the inflection point of DBP was 80 mm Hg. When DBP was ≥80 mm Hg, the bleeding risk increased by 59% (HR: 1.59; 95% CI: 1.16, 2.19; p<0.05) for every 5 mm Hg increase in DBP. Conclusion: Upon achieving an optimal SBP (120–140 mm Hg), a higher DBP might be associated with a higher bleeding risk in patients with NVAF treated with dabigatran.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-11823atrial fibrillationbleedingblood pressuredabigatranhypertension |
| spellingShingle | Yu Yu Minghui Li Wei Zhou Tao Wang Lingjuan Zhu Lihua Hu Huihui Bao Xiaoshu Cheng Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study Anatolian Journal of Cardiology atrial fibrillation bleeding blood pressure dabigatran hypertension |
| title | Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study |
| title_full | Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study |
| title_fullStr | Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study |
| title_full_unstemmed | Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study |
| title_short | Diastolic blood pressure achieved at target systolic blood pressure (120–140 mm Hg) and dabigatran-related bleeding in patients with nonvalvular atrial fibrillation: A real-world study |
| title_sort | diastolic blood pressure achieved at target systolic blood pressure 120 140 mm hg and dabigatran related bleeding in patients with nonvalvular atrial fibrillation a real world study |
| topic | atrial fibrillation bleeding blood pressure dabigatran hypertension |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-11823 |
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