AIM To study the correlation between low density lipoprotein cholesterol (LDL-C) and HAS-BLED bleeding score in elderly patients with comorbid nonvalvular atrial fibrillation for lipid-lowering and anticoagulant therapy.
METHODS According to the criterion, 260 elderly patients of our hospital from January 2018 to June 2020 with comorbid nonvalvular atrial fibrillation (NVAF) and CHA2DS2-VASc≥2 were recruited. According to the HAS-BLED score, they were divided into low-risk group (HAS-BLED < 3, n = 156) and high-risk group (HAS-BLED ≥ 3, n = 104), Binary logistic regression and Pearson correlation were used to analyze the correlation between the LDL-C and the HAS-BLED score.
RESULTS The LDL-C level of low-bleed-risk group (2.3 ± 0.8) mmol/L was significantly higher than that in high-bleeding-risk group (2.0 ± 0.6 mmol/L). Pearson correlation analysis showed that there was a significant correlation between HAS-BLED and LDL-C (r = −0.197, P<0.01). Binary logistic regression analysis showed that LDL-C<1.8 mmol/l was positively correlated with the increased risk of bleeding. After adjusting for confounding variables, the correlation still existed independently (OR = 0.310, 95%CI: 0.117-0.820, P = 0.018). No significant association was found between lower LDL-C level (<2.6 mmol/L) and HAS-BLED groups.
CONCLUSION LDL-C<1.8 mmol/L may be one of the risk factors of increased risk of bleeding in elderly patients with comorbidity non-valvular atrial fibrillation and high risk of thrombosis (CHA2DS2-VASC≥2). It is suggested that the level of LDL-C of patients with this disease should be carefully controlled less than 1.8 mmol/L.
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