Body mass index is an independent predictor of major bleeding in non-valvular atrial fibrillation patients taking dabigatran

Background/Objectives 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 20 months to monitor the occurrence of the bleeding complications. The patients were divided into three study groups according to the BMI tertile ( tertile 1: ≦ 23.9 kg/m², n = 273; tertile 2: 23.9 < BMI ≦ 26.5 kg/m², n = 290; and tertile 3: > 26.5 kg/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.