Krittayaphong Rungroj, Chichareon Ply, Komoltri Chulalak, Kornbongkotmas Sakaorat, Yindeengam Ahthit, Lip Gregory Y H
Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Cardiology unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkla 90110, Thailand.
J Clin Med. 2020 Aug 22;9(9):2713. doi: 10.3390/jcm9092713.
We aimed to determine if low body weight (LBW) status (<50 kg) is independently associated with increased risk of ischemic stroke and bleeding in Thai patients with non-valvular atrial fibrillation (NVAF). (1) Background: It has been unclear whether LBW influence clinical outcome of patients with NVAF. (2) Methods: This prospective multicenter cohort study included patients enrolled in the COOL-AF Registry. The following data were collected: demographic data, medical history, risk factors and comorbid conditions, laboratory and investigation data, and medications. Follow-up data were collected every 6 months. Clinical events during follow-up were confirmed by the adjudication committee. (3) Results: A total of 3367 patients were enrolled. The mean age was 67.2 ± 11.2 years. LBW was present in 338 patients (11.3%). Anticoagulant and antiplatelet was prescribed in 75.3% and 26.2% of patients, respectively. Ischemic stroke, major bleeding, intracerebral hemorrhage (ICH), and death occurred during follow-up in 2.9%, 4.4%, 1.4%, and 7.7% of patients, respectively, during 25.7 months follow-up. LBW was an independent predictor of ischemic stroke, major bleeding, ICH, and death, with a hazard ratio of 2.40, 1.79, 2.37, and 2.65, respectively. (4) Conclusions: LBW was independently associated with increased risk of adverse outcomes in Thai patients with NVAF. This should be carefully considered when balancing the risks and benefits of stroke prevention among patients with different body weights.
我们旨在确定低体重（<50千克）状态是否与泰国非瓣膜性心房颤动（NVAF）患者缺血性卒中和出血风险增加独立相关。（1）背景：低体重是否影响NVAF患者的临床结局尚不清楚。（2）方法：这项前瞻性多中心队列研究纳入了参加COOL-AF注册研究的患者。收集了以下数据：人口统计学数据、病史、危险因素和合并症、实验室和检查数据以及用药情况。每6个月收集一次随访数据。随访期间的临床事件由判定委员会确认。（3）结果：共纳入3367例患者。平均年龄为67.2±11.2岁。338例患者（11.3%）存在低体重。分别有75.3%和26.2%的患者使用了抗凝药和抗血小板药。在25.7个月的随访期间，分别有2.9%、4.4%、1.4%和7.7%的患者在随访期间发生了缺血性卒中、大出血、脑出血（ICH）和死亡。低体重是缺血性卒中、大出血、ICH和死亡的独立预测因素，危险比分别为2.40、1.79、2.37和2.65。（4）结论：在泰国NVAF患者中，低体重与不良结局风险增加独立相关。在权衡不同体重患者预防卒中风险和获益时应仔细考虑这一点。
