ArticleThe American journal of medicine2017
Impact of Body Mass Index and Genetics on Warfarin Major Bleeding Outcomes in a Community Setting.
Article in The American journal of medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 23 citations in OpenAlex.
- Harnessing Risk Assessment for Thrombosis and Bleeding to Optimize Anticoagulation Strategy in Nonvalvular Atrial Fibrillation.Thrombosis and haemostasis · 2025Article
- Association between gene polymorphisms and initial warfarin therapy in patients after heart valve surgery.Pharmacological reports : PR · 2024Article
- Article
- Evaluation of Anticoagulation Control among Patients Taking Warfarin in University of Gondar Hospital, Northwest Ethiopia.Advances in hematology · 2021Article
- Article
- Stroke and Bleeding Risk Assessments in Patients With Atrial Fibrillation: Concepts and Controversies.Frontiers in medicine · 2020Review
- A retrospective study on the risk factors for bleeding events in warfarin therapy, focusing on renal function.European journal of clinical pharmacology · 2017Article
- Polymorphisms of VKORC1 and CYP2C9 are associated with warfarin sensitivity in Chinese population.Therapeutics and clinical risk management · 2017Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundSeveral studies have demonstrated an association between body mass index (BMI) and warfarin therapeutic dose, but none evaluated the association of BMI with the clinically important outcome of major bleeding in a community setting. To address this evidence gap, we conducted a case-control study to evaluate the association between BMI and major bleeding risk among patients receiving warfarin.
methodsWe used a case-control study design to evaluate the association between obesity (BMI >30.0 kg/m
resultsOverall, the sample was 55% male, 94% Caucasian, and mean age was 70 years. Cases and controls had an average of 3.4 and 3.7 years of warfarin use, respectively. Obese patients had significantly lower major bleeding risk relative to non-obese patients (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.39-0.92). The OR was 0.56 (95% CI 0.35-0.90) in patients with ≥1 year of warfarin use, and 0.78 (95% CI 0.40-1.54) in patients with <1 year of warfarin use. An exploratory analysis indicated a statistically significant interaction between CYP4F2*3 genetic status and obesity (P = .049), suggesting a protective effect of obesity on the risk of major bleeding among those wild type for CYP4F2*3, but not among variants.
conclusionsOur findings suggest that BMI is an important clinical factor in assessing and managing warfarin therapy. Future studies should confirm the major bleeding associations, including the interaction between obesity and CYP4F2*3 status identified in this study, and evaluate potential mechanisms.
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