Arrhythmias & electrophysiologySecondary analysis
Pre-treatment lysis time of plasma-derived fibrin clots and bleeding in patients on oral anticoagulants for atrial fibrillation in the ARISTOTLE trial
- Secondary analysis of the ARISTOTLE randomised trial
- biomarker substudy
Authors' conclusion
Shorter pre-treatment fibrin clot lysis time independently predicted higher bleeding risk in patients receiving oral anticoagulation for AF.
Study context
- Population
- Anticoagulation-naïve patients with atrial fibrillation (AF) in ARISTOTLE, plasma sampled before study medication
- Participants
- 1,841 patients
- Comparison
- Fibrin clot lysis time quartiles
- Primary endpoint
- Major and clinically relevant non-major bleeding
Primary result
As reported in the abstract
Q1
6.3%/yr
Q4
2.1%/yr
Each group vs Q4HRP value
Q1
2.99(95% CI 1.75–5.12)
P = 0.001Q1multifactorial adjustment
2.61(CI 1.45–4.69)
P = 0.016Q2
2.21(CI 1.27–3.87)
Q3
2.08(CI 1.18–3.66)
Further findings
CV death, stroke, systemic embolism or MI
- No significant association with lysis time
Characteristics associated with shorter lysis time
- Older, male, permanent AF, lower BMI, eGFR and C-reactive protein, higher NT-proBNP
Original publication
Pre-treatment lysis time of plasma-derived fibrin clots and bleeding in patients on oral anticoagulants for atrial fibrillation in the ARISTOTLE trial. Eur Heart J. Published 30 May 2025. doi:10.1093/eurheartj/ehaf347
Summarised from the published abstract; every number is checked against it