Cargando…

Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure

Constipation has been reported to increase the risk of cardiovascular mortality. Patients with atrial fibrillation (AF) and heart failure (HF) have more comorbidities and an increased bleeding risk. However, it remains unclear whether constipation is associated with an increased risk of incident ble...

Descripción completa

Detalles Bibliográficos
Autores principales: Yamamoto, Jumpei, Yamamoto, Masaya, Hara, Hisao, Hiroi, Yukio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Japan 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209255/
https://www.ncbi.nlm.nih.gov/pubmed/36799967
http://dx.doi.org/10.1007/s00380-023-02249-6
_version_ 1785046837813575680
author Yamamoto, Jumpei
Yamamoto, Masaya
Hara, Hisao
Hiroi, Yukio
author_facet Yamamoto, Jumpei
Yamamoto, Masaya
Hara, Hisao
Hiroi, Yukio
author_sort Yamamoto, Jumpei
collection PubMed
description Constipation has been reported to increase the risk of cardiovascular mortality. Patients with atrial fibrillation (AF) and heart failure (HF) have more comorbidities and an increased bleeding risk. However, it remains unclear whether constipation is associated with an increased risk of incident bleeding complications in AF with HF. Here, we investigated the association between constipation requiring laxatives and major bleeding in AF and HF. We retrospectively analyzed the medical records of 370 consecutive patients hospitalized for AF and congestive HF. Constipation was defined as regularly taking laxatives or having at least two prescriptions for a ≥ 30-day supply of laxatives. Sixty patients experienced major bleeding events during a median follow-up of 318 days. The most common sites of bleeding were lower gastrointestinal (28%, 17/60), upper gastrointestinal (27%, 16/60), and intracranial (20%, 12/60). There were 33 (55%) patients with constipation in the bleeding group and 107 (35%) in the non-bleeding group (P = 0.004). Multivariate Cox regression analysis adjusted for HAS-BLED score, hemoglobin, and direct oral anticoagulant use showed that constipation (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.11–3.08; p = 0.019) was a significant risk factor for major bleeding. We found a significant association between constipation requiring laxatives and major bleeding in patients with AF and HF. These findings indicate the need for constipation prevention in these patients to avoid reliance on invasive defecation management, including laxatives. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00380-023-02249-6.
format Online
Article
Text
id pubmed-10209255
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Japan
record_format MEDLINE/PubMed
spelling pubmed-102092552023-05-26 Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure Yamamoto, Jumpei Yamamoto, Masaya Hara, Hisao Hiroi, Yukio Heart Vessels Original Article Constipation has been reported to increase the risk of cardiovascular mortality. Patients with atrial fibrillation (AF) and heart failure (HF) have more comorbidities and an increased bleeding risk. However, it remains unclear whether constipation is associated with an increased risk of incident bleeding complications in AF with HF. Here, we investigated the association between constipation requiring laxatives and major bleeding in AF and HF. We retrospectively analyzed the medical records of 370 consecutive patients hospitalized for AF and congestive HF. Constipation was defined as regularly taking laxatives or having at least two prescriptions for a ≥ 30-day supply of laxatives. Sixty patients experienced major bleeding events during a median follow-up of 318 days. The most common sites of bleeding were lower gastrointestinal (28%, 17/60), upper gastrointestinal (27%, 16/60), and intracranial (20%, 12/60). There were 33 (55%) patients with constipation in the bleeding group and 107 (35%) in the non-bleeding group (P = 0.004). Multivariate Cox regression analysis adjusted for HAS-BLED score, hemoglobin, and direct oral anticoagulant use showed that constipation (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.11–3.08; p = 0.019) was a significant risk factor for major bleeding. We found a significant association between constipation requiring laxatives and major bleeding in patients with AF and HF. These findings indicate the need for constipation prevention in these patients to avoid reliance on invasive defecation management, including laxatives. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00380-023-02249-6. Springer Japan 2023-02-17 2023 /pmc/articles/PMC10209255/ /pubmed/36799967 http://dx.doi.org/10.1007/s00380-023-02249-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Yamamoto, Jumpei
Yamamoto, Masaya
Hara, Hisao
Hiroi, Yukio
Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title_full Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title_fullStr Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title_full_unstemmed Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title_short Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
title_sort relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209255/
https://www.ncbi.nlm.nih.gov/pubmed/36799967
http://dx.doi.org/10.1007/s00380-023-02249-6
work_keys_str_mv AT yamamotojumpei relationbetweenlaxativeuseandriskofmajorbleedinginpatientswithatrialfibrillationandheartfailure
AT yamamotomasaya relationbetweenlaxativeuseandriskofmajorbleedinginpatientswithatrialfibrillationandheartfailure
AT harahisao relationbetweenlaxativeuseandriskofmajorbleedinginpatientswithatrialfibrillationandheartfailure
AT hiroiyukio relationbetweenlaxativeuseandriskofmajorbleedinginpatientswithatrialfibrillationandheartfailure