Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants

Yu Feng Hu, Shih Lin Chang, Chang Ming Chern, Cheng Hsueh Wu, Yenn Jiang Lin, Li Wei Lo, Tze Fan Chao, Fa Po Chung, Jo Nan Liao, Ting Yung Chang, Ting Chun Huang, Cheng I. Wu, Chih Min Liu, Simon Salim, Jennifer Jeanne Vicera, Le Phat Tai, Shih Ann Chen

研究成果: Article

1 引文 (Scopus)

摘要

Whether bleeding should be considered a sufficient sign to justify thorough cancer surveillance in atrial fibrillation (AF) patients receiving nonvitamin K antagonist oral anticoagulants (NOACs) remains unclear. We investigated the relationships between bleeding events and new-onset cancers in AF patients receiving NOACs in a prospective cohort (n = 395, mean follow-up duration of 2.8 years). There were 18 patients who were diagnosed with new-onset cancers 584 ± 372 days after the initiation of NOACs. The patients with new-onset cancers had higher HAS-BLED scores (no, preexisting and new-onset cancer: 1.51 ± 0.81, 1.69 ± 0.87, and 2.11 ± 0.96, respectively; p = 0.006) and a higher incidence of bleeding events (22%, 33%, 67%, respectively; p<0.001) than did patients without new-onset cancers. Bleeding events that preceded the diagnosis of new-onset cancers were independently correlated with new-onset cancers (odds ratio: 7.89, p = 0.001) in the multivariate logistic regression. More than half of the patients (61%) with new-onset cancers had either a significant period of drug interruption for at least 2 months or discontinued NOACs. In conclusions, bleeding in AF patients receiving NOACs could be an alerting sign of new-onset cancers and should prompt the initiation of thorough surveillance to detect early cancers.

原文English
頁(從 - 到)782-786
頁數5
期刊American Journal of Cardiology
123
發行號5
DOIs
出版狀態Published - 2019 三月 1

指紋

Anticoagulants
Atrial Fibrillation
Hemorrhage
Neoplasms
Logistic Models
Odds Ratio
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

引用此文

Hu, Yu Feng ; Chang, Shih Lin ; Chern, Chang Ming ; Wu, Cheng Hsueh ; Lin, Yenn Jiang ; Lo, Li Wei ; Chao, Tze Fan ; Chung, Fa Po ; Liao, Jo Nan ; Chang, Ting Yung ; Huang, Ting Chun ; Wu, Cheng I. ; Liu, Chih Min ; Salim, Simon ; Vicera, Jennifer Jeanne ; Tai, Le Phat ; Chen, Shih Ann. / Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants. 於: American Journal of Cardiology. 2019 ; 卷 123, 編號 5. 頁 782-786.
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title = "Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants",
abstract = "Whether bleeding should be considered a sufficient sign to justify thorough cancer surveillance in atrial fibrillation (AF) patients receiving nonvitamin K antagonist oral anticoagulants (NOACs) remains unclear. We investigated the relationships between bleeding events and new-onset cancers in AF patients receiving NOACs in a prospective cohort (n = 395, mean follow-up duration of 2.8 years). There were 18 patients who were diagnosed with new-onset cancers 584 ± 372 days after the initiation of NOACs. The patients with new-onset cancers had higher HAS-BLED scores (no, preexisting and new-onset cancer: 1.51 ± 0.81, 1.69 ± 0.87, and 2.11 ± 0.96, respectively; p = 0.006) and a higher incidence of bleeding events (22{\%}, 33{\%}, 67{\%}, respectively; p<0.001) than did patients without new-onset cancers. Bleeding events that preceded the diagnosis of new-onset cancers were independently correlated with new-onset cancers (odds ratio: 7.89, p = 0.001) in the multivariate logistic regression. More than half of the patients (61{\%}) with new-onset cancers had either a significant period of drug interruption for at least 2 months or discontinued NOACs. In conclusions, bleeding in AF patients receiving NOACs could be an alerting sign of new-onset cancers and should prompt the initiation of thorough surveillance to detect early cancers.",
author = "Hu, {Yu Feng} and Chang, {Shih Lin} and Chern, {Chang Ming} and Wu, {Cheng Hsueh} and Lin, {Yenn Jiang} and Lo, {Li Wei} and Chao, {Tze Fan} and Chung, {Fa Po} and Liao, {Jo Nan} and Chang, {Ting Yung} and Huang, {Ting Chun} and Wu, {Cheng I.} and Liu, {Chih Min} and Simon Salim and Vicera, {Jennifer Jeanne} and Tai, {Le Phat} and Chen, {Shih Ann}",
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Hu, YF, Chang, SL, Chern, CM, Wu, CH, Lin, YJ, Lo, LW, Chao, TF, Chung, FP, Liao, JN, Chang, TY, Huang, TC, Wu, CI, Liu, CM, Salim, S, Vicera, JJ, Tai, LP & Chen, SA 2019, 'Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants', American Journal of Cardiology, 卷 123, 編號 5, 頁 782-786. https://doi.org/10.1016/j.amjcard.2018.11.046

Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants. / Hu, Yu Feng; Chang, Shih Lin; Chern, Chang Ming; Wu, Cheng Hsueh; Lin, Yenn Jiang; Lo, Li Wei; Chao, Tze Fan; Chung, Fa Po; Liao, Jo Nan; Chang, Ting Yung; Huang, Ting Chun; Wu, Cheng I.; Liu, Chih Min; Salim, Simon; Vicera, Jennifer Jeanne; Tai, Le Phat; Chen, Shih Ann.

於: American Journal of Cardiology, 卷 123, 編號 5, 01.03.2019, p. 782-786.

研究成果: Article

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T1 - Bleeding and New-Onset Cancers in Patients With Atrial Fibrillation Receiving Nonvitamin K Antagonist Oral Anticoagulants

AU - Hu, Yu Feng

AU - Chang, Shih Lin

AU - Chern, Chang Ming

AU - Wu, Cheng Hsueh

AU - Lin, Yenn Jiang

AU - Lo, Li Wei

AU - Chao, Tze Fan

AU - Chung, Fa Po

AU - Liao, Jo Nan

AU - Chang, Ting Yung

AU - Huang, Ting Chun

AU - Wu, Cheng I.

AU - Liu, Chih Min

AU - Salim, Simon

AU - Vicera, Jennifer Jeanne

AU - Tai, Le Phat

AU - Chen, Shih Ann

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Whether bleeding should be considered a sufficient sign to justify thorough cancer surveillance in atrial fibrillation (AF) patients receiving nonvitamin K antagonist oral anticoagulants (NOACs) remains unclear. We investigated the relationships between bleeding events and new-onset cancers in AF patients receiving NOACs in a prospective cohort (n = 395, mean follow-up duration of 2.8 years). There were 18 patients who were diagnosed with new-onset cancers 584 ± 372 days after the initiation of NOACs. The patients with new-onset cancers had higher HAS-BLED scores (no, preexisting and new-onset cancer: 1.51 ± 0.81, 1.69 ± 0.87, and 2.11 ± 0.96, respectively; p = 0.006) and a higher incidence of bleeding events (22%, 33%, 67%, respectively; p<0.001) than did patients without new-onset cancers. Bleeding events that preceded the diagnosis of new-onset cancers were independently correlated with new-onset cancers (odds ratio: 7.89, p = 0.001) in the multivariate logistic regression. More than half of the patients (61%) with new-onset cancers had either a significant period of drug interruption for at least 2 months or discontinued NOACs. In conclusions, bleeding in AF patients receiving NOACs could be an alerting sign of new-onset cancers and should prompt the initiation of thorough surveillance to detect early cancers.

AB - Whether bleeding should be considered a sufficient sign to justify thorough cancer surveillance in atrial fibrillation (AF) patients receiving nonvitamin K antagonist oral anticoagulants (NOACs) remains unclear. We investigated the relationships between bleeding events and new-onset cancers in AF patients receiving NOACs in a prospective cohort (n = 395, mean follow-up duration of 2.8 years). There were 18 patients who were diagnosed with new-onset cancers 584 ± 372 days after the initiation of NOACs. The patients with new-onset cancers had higher HAS-BLED scores (no, preexisting and new-onset cancer: 1.51 ± 0.81, 1.69 ± 0.87, and 2.11 ± 0.96, respectively; p = 0.006) and a higher incidence of bleeding events (22%, 33%, 67%, respectively; p<0.001) than did patients without new-onset cancers. Bleeding events that preceded the diagnosis of new-onset cancers were independently correlated with new-onset cancers (odds ratio: 7.89, p = 0.001) in the multivariate logistic regression. More than half of the patients (61%) with new-onset cancers had either a significant period of drug interruption for at least 2 months or discontinued NOACs. In conclusions, bleeding in AF patients receiving NOACs could be an alerting sign of new-onset cancers and should prompt the initiation of thorough surveillance to detect early cancers.

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