SERAFINO MANSUETO AWARD | Low-density lipoprotein cholesterol levels and bleeding during anticoagulation for venous hromboembolism
Year: 2025
Type: article
Study design: Observational Study
Abstract: Premises and Purpose of the study: The association between low-density lipoprotein cholesterol (LDL-C) levels and bleeding in patients receiving anticoagulant therapy for venous thromboembolism (VTE) has not been previously explored. While low LDL-C levels are beneficial for reducing cardiovascular events, their impact on bleeding risk in VTE patients remains uncertain. Materials and Methods: This observational prospective case-control study utilized data from the Registro RIETE. Enrolled patients have a follow up of 90-days. All patients with objectively documented acute deep vein thrombosis (DVT) or pulmonary embolism (PE) are recruited. We aimed to assess the influence of baseline LDL-C levels on bleeding risk during the first 90 days of anticoagulation in 19,237 VTE patients. Multivariable analyses were conducted to evaluate the association between LDL-C levels (<70 mg/dL vs ≥70 mg/dL) and bleeding outcomes. Results: Of 19,237 patients, 2,502 (13.0%) had LDL-C levels <70 mg/dL. During the first 90 days, 743 patients (3.9%) experienced bleeding events (294 major bleeding, 449 non-major bleeding, 32 fatal bleeding). On multivariable analysis, LDL-C levels <70 mg/dL were associated with a higher risk of overall bleeding (adjusted hazard ratio [aHR]: 1.44; 95%CI: 1.19-1.74). The heightened bleeding risk appeared early in treatment and was primarily linked to hematoma formation (aHR: 2.11; 95%CI: 1.49-2.98). Conclusions: In VTE patients receiving anticoagulation, LDL-C levels <70 mg/dL were independently associated with an increased risk of bleeding, particularly hematomas.
Source: Italian Journal of Medicine
Authors: Vo Van Kha, Tran Thi Huong Ly, Pham Thi Thanh Hoa, Vo Huynh Nhu, Damas Hendriansyah, Nusratuddin Abdullah, Rudy B. Leonardy, Mardiah Tahir, Samrichard Rambulangi, Firdaus Hamid, Filomena Pietrantonio, Vera Kopsaj, Francesco Rosiello, Aurora Tomassoni, Luca Moriconi, Donatella Padua, Kiki Rizki Amelia, Efendi Lukas, Nurbani Bangsawan, Isharyah Sunarno, Retno Budiarti Farid, Sriwijaya Qadar, Rabab H. Elshaikh, Ashok Kumar Sah, Abdelrahman Mohamed Abukanna, Abdulrahman Algarni, Ammar Abdelmola, Hussam Ali Osman, Tagwa Yousif Elsayed Yousif, Elryah I. Ali, Hiba Ali, Ayman Hussein Alfeel, Thanh Long Nguyen, Victor Storm, Lam Toi Phung, Cong Thien Le, Thi Thu Ha Le, Thi Hoa Nguyen, Son Tung Vu, Thien Thang Tran, Minh Hanh Vu, Van Tuan Nguyen, Francesco Ventrella, Anna Belfiore, Antonio Greco, Franco Mastroianni, Salvatore Lenti, Domenico Ruggiero, Michele Cannone, Vincenzo Ostilio Palmieri, Massimo Errico, Giuseppe Mancia, Guido Grassi, Sverre E. Kjeldsen
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413800970