Risk factors of gastrointestinal bleeding in patients with non-valvular atrial fibrillation taking new oral anticoagulants
Wei Mengke
Sun Yamei
Chen Xue
Zhang Jie
Abstract：Objective To investigate risk factors of gastrointestinal bleeding in patients with non-valvular atrial fibrillation taking new oral anticoagulants.Methods Patients with non-valvular atrial fibrillation taking new oral anticoagulants who were hospitalized in Beijing Anzhen Hospital,Capital Medical University from January 2016 to May 2023 were enrolled.Patients with gastrointestinal bleeding during hospitalization were enrolled as the bleeding group,and were randomly matched 1:2 according to age,sex,and type and dose of new oral anticoagulants.Patients without gastrointestinal bleeding during hospitalization were included as the non-bleeding group.The general information,comorbidities,drug use,laboratory indicators and other information of patients in the two groups were collected.Logistic regression analysis was used to explore the risk factors of gastrointestinal bleeding in patients with non-valvular atrial fibrillation taking new oral anticoagulants.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to evaluate the predictive value of risk factors for gastrointestinal bleeding in patients with non-valvular atrial fibrillation taking new oral anticoagulants.Results A total of 153 patients taking new oral anticoagulants were enrolled,including 51 patients in bleeding group and 102 patients in non-bleeding group.The proportions of patients with coronary atherosclerotic heart disease,cardiac insufficiency,previous gastrointestinal bleeding history,peptic ulcer,anemia,chronic renal insufficiency,venous thromboembolism and peripheral vascular disease in the bleeding group were higher than those in the non-bleeding group(all P＜0.05).The level of hemoglobin in bleeding group was lower than that in non-bleeding group,and the levels of neutrophil percentage,blood urea nitrogen and D-dimer were higher than those in non-bleeding group(all P＜0.05).Multivariate Logistic regression analysis showed that coronary atherosclerotic heart disease[odds ratio(OR)=4.678,95％confidence interval(CI):1.600-13.677],history of gastrointestinal bleeding(OR=9.906,95％CI:1.449-67.742),chronic renal insufficiency(OR=4.893,95％CI:1.122-21.330),anemia(OR=13.487,95％CI:1.847-98.496),and D-dimer(OR=1.001,95％CI:1.000-1.003)were independent risk factors for gastrointestinal bleeding in the treatment of non-valvular atrial fibrillation with new oral anticoagulants.ROC curve was drawn by combining the above indicators,and the AUC was 0.905(95％CI:0.854-0.955,P＜0.001).Conclusion Coronary atherosclerotic heart disease,history of gastrointestinal bleeding,chronic renal insufficiency,anemia and D-dimer are independent risk factors for gastroin-testinal bleeding in patients with non-valvular atrial fibrillation treated with new oral anticoagulants.
Keywords：Non-valvular atrial fibrillationNew oral anticoagulantsGastrointestinal bleedingRisk factors
Publication Date：2024-01-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 20-24 )