Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)

Background. The rate of major bleeding in patients with atrial fibrillation receiving oral anticoagulants is 25% per year. Gastrointestinal bleedings are at least a half of major hemorrhagic complications. Currently, there is no optimal scale to calculate the risk of bleeding, and therefore the sear...

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Autores principales:	Ekaterina S. Kropacheva, Mariia B. Khakimova, Elena N. Krivosheeva, Oksana A. Zemlyanskaya, Elizaveta P. Panchenko
Formato:	article
Lenguaje:	RU
Publicado:	"Consilium Medicum" Publishing house 2021
Materias:	atrial fibrillation oral anticoagulants gastrointestinal bleeding Medicine R
Acceso en línea:	https://doaj.org/article/95de1ac080cc44c688844fc284f355f6
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spelling	oai:doaj.org-article:95de1ac080cc44c688844fc284f355f62021-12-01T12:22:36ZSevere gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)0040-36602309-534210.26442/00403660.2021.09.201019https://doaj.org/article/95de1ac080cc44c688844fc284f355f62021-09-01T00:00:00Zhttps://ter-arkhiv.ru/0040-3660/article/viewFile/82965/63440https://doaj.org/toc/0040-3660https://doaj.org/toc/2309-5342Background. The rate of major bleeding in patients with atrial fibrillation receiving oral anticoagulants is 25% per year. Gastrointestinal bleedings are at least a half of major hemorrhagic complications. Currently, there is no optimal scale to calculate the risk of bleeding, and therefore the search for clinical predictors of gastrointestinal bleeding remains relevant. Aim. To assess the frequency and structure of large gastrointestinal bleeding, as well as to identify clinical predictors of their development based on long-term prospective observation of patients with atrial fibrillation receiving oral anticoagulants. Materials and methods. Data were obtained from single center prospective REGistry of long-term AnTithrombotic TherApy (REGATTA NCT043447187). Investigation based on a 20-year follow-up with 510 patients with atrial fibrillation with a high thromboembolic risk (median CHA2DS2-VASc was 4 points). The REGATTA registry assessed the frequency and structure of major gastrointestinal bleeding. Predictors of the development of 32 large gastrointestinal bleeding were identified based on the analysis of pairs with univariate and multivariate analyses. Results. The frequency of major gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants at 1 year was 1.42 per 100 patients; the predominant localization was upper gastrointestinal tract. Predictors of the development of major gastrointestinal bleeding according to multiple regression data analysis were hemoglobin level 14.55 g/dL, body mass index 28.4 kg/m2, gastrointestinal ulcer or erosive lesion and major hemorrhagic complications in history of disease. In 1/2 cases the sourse of bleeding remained unclear. Conclusion. Searching for clinical predictors of gastrointestinal bleeding can identify patients receiving oral anticoagulants who is need of intensive monitoring risk factors to prevent the development of life-threatening bleeding and to provide with adequate anticoagulant therapy.Ekaterina S. KropachevaMariia B. KhakimovaElena N. KrivosheevaOksana A. ZemlyanskayaElizaveta P. Panchenko"Consilium Medicum" Publishing housearticleatrial fibrillationoral anticoagulantsgastrointestinal bleedingMedicineRRUТерапевтический архив, Vol 93, Iss 9, Pp 1037-1043 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	atrial fibrillation oral anticoagulants gastrointestinal bleeding Medicine R
spellingShingle	atrial fibrillation oral anticoagulants gastrointestinal bleeding Medicine R Ekaterina S. Kropacheva Mariia B. Khakimova Elena N. Krivosheeva Oksana A. Zemlyanskaya Elizaveta P. Panchenko Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
description	Background. The rate of major bleeding in patients with atrial fibrillation receiving oral anticoagulants is 25% per year. Gastrointestinal bleedings are at least a half of major hemorrhagic complications. Currently, there is no optimal scale to calculate the risk of bleeding, and therefore the search for clinical predictors of gastrointestinal bleeding remains relevant. Aim. To assess the frequency and structure of large gastrointestinal bleeding, as well as to identify clinical predictors of their development based on long-term prospective observation of patients with atrial fibrillation receiving oral anticoagulants. Materials and methods. Data were obtained from single center prospective REGistry of long-term AnTithrombotic TherApy (REGATTA NCT043447187). Investigation based on a 20-year follow-up with 510 patients with atrial fibrillation with a high thromboembolic risk (median CHA2DS2-VASc was 4 points). The REGATTA registry assessed the frequency and structure of major gastrointestinal bleeding. Predictors of the development of 32 large gastrointestinal bleeding were identified based on the analysis of pairs with univariate and multivariate analyses. Results. The frequency of major gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants at 1 year was 1.42 per 100 patients; the predominant localization was upper gastrointestinal tract. Predictors of the development of major gastrointestinal bleeding according to multiple regression data analysis were hemoglobin level 14.55 g/dL, body mass index 28.4 kg/m2, gastrointestinal ulcer or erosive lesion and major hemorrhagic complications in history of disease. In 1/2 cases the sourse of bleeding remained unclear. Conclusion. Searching for clinical predictors of gastrointestinal bleeding can identify patients receiving oral anticoagulants who is need of intensive monitoring risk factors to prevent the development of life-threatening bleeding and to provide with adequate anticoagulant therapy.
format	article
author	Ekaterina S. Kropacheva Mariia B. Khakimova Elena N. Krivosheeva Oksana A. Zemlyanskaya Elizaveta P. Panchenko
author_facet	Ekaterina S. Kropacheva Mariia B. Khakimova Elena N. Krivosheeva Oksana A. Zemlyanskaya Elizaveta P. Panchenko
author_sort	Ekaterina S. Kropacheva
title	Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
title_short	Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
title_full	Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
title_fullStr	Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
title_full_unstemmed	Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)
title_sort	severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on registry of long-term antithrombotic therapy – regatta)
publisher	"Consilium Medicum" Publishing house
publishDate	2021
url	https://doaj.org/article/95de1ac080cc44c688844fc284f355f6
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Severe gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants (based on REGistry of long-term AnTithrombotic TherApy – REGATTA)

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