Arrhythmias & electrophysiology
Albumin level and risk of major bleeding in patients with atrial fibrillation on direct oral anticoagulants
Main findingResult — go to the resultAdjusted hazard ratio 0.61 95% CI 0.47–0.80Authors' conclusion
A lower albumin level was independently associated with a higher bleeding risk in AF patients using DOACs. Careful attention should be paid to hypoalbuminemia when prescribing DOACs.
Study context
- Population
- Atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs) with albumin data available at enrolmentpatients with albumin data available at enrolment, out of the DIRECT-Extend registry (N = 7512), 73 (IQR 66–80) years, 1620 (64.2%) males
- Participants
- 2,523 participants
- Exposure
- Association between albumin levels and bleeding risk
- Outcome
- Major bleeding as defined by International Society on Thrombosis and Haemostasis criteria
- Follow-up
- Median was 532 days (IQR 94-1405 days)
Methodological detailsDIRECT-Extend registry
- DIRECT-Extend registry
Main finding
As reported in the abstract
Adjusted hazard ratio
0.61
95% CI 0.47–0.80
P < 0.01
Events by group
Albumin level
adjusted hazard ratio 0.61 (95% CI 0.47–0.80); P < 0.01
- Log-rank test
- P < 0.0001
Observational data: associations, not effects.
Original publication
Albumin level and risk of major bleeding in patients with atrial fibrillation on direct oral anticoagulants. Eur Heart J Cardiovasc Pharmacother. Published 24 April 2025. doi:10.
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