title: Body mass index is an independent predictor of major bleeding in non-valvular atrial fibrillation patients taking dabigatran.
abstract: OBJECTIVE
  Adverse bleeding events happened more frequently among individuals with, or at risk of, a low body mass index (BMI) than others. Despite increasing use of dabigatran in atrial fibrillation (AF) patients, the relationship between individual BMI and major bleeding events has not been clearly elucidated.
  
  
  METHODS
  This study was an observational study of 842 patients who were enrolled and were followed up for a median of 20months to monitor the occurrence of the bleeding complications. The patients were divided into three study groups according to the BMI tertile ( tertile 1: ≦23.9kg/m2, n=273; tertile 2: 23.9<BMI≦26.5kg/m2, n=290; and tertile 3: >26.5kg/m2, n=279).
  
  
  RESULTS
  During follow-up, 28 participants suffered from bleeding events. BMI was significant predictor of hospitalization for major bleeding (BMI, hazard ratio (HR) 0.830, p=0.002). The incorporation of BMI tertile significantly improved the outputs of a model that was based on continuous age and HAS-BLED score without age component (p=0.001).
  
  
  CONCLUSIONS
  Lower BMI is associated with higher incidence of major bleeding in these patients. BMI may improve the prediction of an increased individual bleeding risk of a patient with AF who has been treated with dabigatran.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Chen-Hung
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Clinical Pharmacy Service, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan.
authors.forename: Tzu-Yu
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Shang-Hung
authors.initials: SH
authors.lastname: Chang
authors.affiliation: Department of Clinical Pharmacy Service, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan.
authors.forename: Chi-Hua
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Management Information System, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ying-Jen
authors.initials: YJ
authors.lastname: Hsu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan. Electronic address: hungkuochun@yahoo.com.tw.
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D015992:Body Mass Index; D015331:Cohort Studies; D000069604:Dabigatran / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control
chemical_list: D000991:Antithrombins; D000069604:Dabigatran