Yurong Xiong1, Wei Zhou2, Minghui Li1, Tao Wang1, Xiao Huang1, Huihui Bao1,2, Xiaoshu Cheng1,2. 1. Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China. 2. Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
Abstract
BACKGROUND: A reduction in platelet count or function can be a risk factor for bleeding in anticoagulated patients. However, the association between platelet count and the risk of bleeding among nonvalvular atrial fibrillation (NVAF) patients taking dabigatran remains unclear. The aim of this study was to investigate the relationship between platelet count and the risk of bleeding among patients with NVAF taking dabigatran after radiofrequency ablation. METHODS: In this multicenter, prospective and observational study, a total of 576 NVAF patients treated with dabigatran (110 mg bid) after radiofrequency ablation were recruited from 12 centers in China from February 2015 to December 2017. All patients were followed for 3 months. The association between platelet count and the risk of bleeding was evaluated by Cox proportional hazards regression analysis. To explore the nonlinearity between platelet count and bleeding, we used a Cox proportional hazards regression model with cubic spline functions and smooth curve fitting and a two-piecewise Cox proportional hazards model. RESULTS: During a median follow-up duration of 87 days, 50 patients experienced bleeding events. Overall, there was an inverse relationship between the risk of bleeding and platelet count. Low platelet count (<100×109/L) were associated with an increased risk of bleeding [hazard ratio (HR), 4.05; 95% confidence interval (CI): 1.32-12.46] compared to normal counts. The adjusted smooth curve showed a nonlinear relationship between platelet count and bleeding events. The inflection point of the platelet count was 105×109/L. For platelet counts <105×109/L, the HR (95% CI) was 0.89 (0.84-0.95), and for platelet counts ≥105×109/L, the HR (95% CI) was 1.01 (0.95-1.08). CONCLUSIONS: Low platelet counts were associated with an increased risk for bleeding among patients with NVAF taking dabigatran after catheter ablation. 2020 Cardiovascular Diagnosis and Therapy. All rights reserved.
BACKGROUND: A reduction in platelet count or function can be a risk factor for bleeding in anticoagulated patients. However, the association between platelet count and the risk of bleeding among nonvalvular atrial fibrillation (NVAF) patients taking dabigatran remains unclear. The aim of this study was to investigate the relationship between platelet count and the risk of bleeding among patients with NVAF taking dabigatran after radiofrequency ablation. METHODS: In this multicenter, prospective and observational study, a total of 576 NVAF patients treated with dabigatran (110 mg bid) after radiofrequency ablation were recruited from 12 centers in China from February 2015 to December 2017. All patients were followed for 3 months. The association between platelet count and the risk of bleeding was evaluated by Cox proportional hazards regression analysis. To explore the nonlinearity between platelet count and bleeding, we used a Cox proportional hazards regression model with cubic spline functions and smooth curve fitting and a two-piecewise Cox proportional hazards model. RESULTS: During a median follow-up duration of 87 days, 50 patients experienced bleeding events. Overall, there was an inverse relationship between the risk of bleeding and platelet count. Low platelet count (<100×109/L) were associated with an increased risk of bleeding [hazard ratio (HR), 4.05; 95% confidence interval (CI): 1.32-12.46] compared to normal counts. The adjusted smooth curve showed a nonlinear relationship between platelet count and bleeding events. The inflection point of the platelet count was 105×109/L. For platelet counts <105×109/L, the HR (95% CI) was 0.89 (0.84-0.95), and for platelet counts ≥105×109/L, the HR (95% CI) was 1.01 (0.95-1.08). CONCLUSIONS: Low platelet counts were associated with an increased risk for bleeding among patients with NVAF taking dabigatran after catheter ablation. 2020 Cardiovascular Diagnosis and Therapy. All rights reserved.
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