RT Journal Article
T1 Prevalence of bleeding secondary to anticoagulation and mortality in patients with atrial fibrillation admitted with SARS-CoV-2 infection
A1 Rubini-Costa, Ricardo
A1 Bermudez-Jimenez, Francisco
A1 Rivera-Lopez, Ricardo
A1 Sola-Garcia, Elena
A1 Nagib-Raya, Hadi
A1 Moreno-Escobar, Eduardo
A1 Angel Lopez-Zuniga, Miguel
A1 Briones-Traves, Adela
A1 Sanz-Herrera, Francisco
A1 Miguel Sequi-Sabater, Jose
A1 Luis Romero-Cabrera, Juan
A1 Maillo-Seco, Javier
A1 Fernandez-Vazquez, Felipe
A1 Rivadeneira-Ruiz, Maria
A1 Lopez-Valero, Lucas
A1 Gomez-Navarro, Carlos
A1 Antonio Aparicio-Gomez, Jose
A1 Lopez, Miguel Alvarez
A1 Tercedor, Luis
A1 Molina-Jimenez, Maria
A1 Macias-Ruiz, Rosa
A1 Jimenez-Jaimez, Juan
K1 COVID-19
K1 Atrial fibrillation
K1 Major bleeding
K1 Mortality
K1 Anticoagulation
K1 Outcomes
K1 Interruption
K1 Covid-19
K1 Disease
AB Introduction and purpose: Atrial fibrillation (AF) is common in patients admitted with severe COVID19. However, there is limited data about the management of chronic anticoagulation therapy in these patients. We assessed the anticoagulation and incidence of major cardiovascular events in hospitalized patients with AF and COVID-19.Methods: We retrospectively investigated all consecutive patients with AF admitted with COVID-19 between March and May 2020 in 9 Spanish hospitals. We selected a control group of non-AF patients consecutively admitted with COVID-19. We compared baseline characteristics, incidence of major bleeding, thrombotic events and mortality. We used propensity score matching (PSM) to minimize potential confounding variables, as well as a multivariate analysis to predict major bleeding and death.Results: 305 patients admitted with AF and COVID-19 were included. After PSM, 151 AF patients were matched with 151 control group patients. During admission, low-molecular-weight heparin was the principal anticoagulant and the incidence of major bleeding and mortality were higher in the AF group [16 (10.6%) vs 3 (2%), p = 0.003; 52 (34.4%) vs 35 (23.2%), p= 0.03, respectively]. The multivariate analysis showed the presence of AF as independent predictor of in-hospital major bleeding and mortality in COVID-19 patients. In AF group, a secondary multivariate analysis identified high levels of D-dimer as independent predictor of in-hospital major bleeding.Conclusions: AF patients admitted with COVID-19 represent a population at high risk for bleeding and mortality during admission. It seems advisable to individualize anticoagulation therapy during admission, considering patient specific bleeding and thrombotic risk. (C) 2021 Elsevier Espafia, S.L.U. All rights reserved.
PB Elsevier espana slu
SN 0025-7753
YR 2022
FD 2022-06-24
LK https://hdl.handle.net/10668/24980
UL https://hdl.handle.net/10668/24980
LA en
DS RISalud
RD Apr 15, 2025