@article{19e742f753074bdd992a7eae7c09757d,
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}",
note = "Funding Information: This work was supported by the Taipei Veterans General Hospital ( V106C-044 , V107C-029 , VGHUST-107-G5-1-2 , VTA106-V1-5-1 ), the Ministry of Science and Technology ( MOST104-2314-B-010-055-MY3 , MOST105-2633-B-075-002 ), the Research Foundation for Cardiovascular Medicine ( 105-02-022 ), Szu-yuan Research Foundation of Internal Medicine ( 107-041 ), and National Health Research Institutes ( NHRIEX107-10513SC , NHRI-EX106-10513SC ). Funding Information: This work was supported by the Taipei Veterans General Hospital (V106C-044, V107C-029, VGHUST-107-G5-1-2, VTA106-V1-5-1), the Ministry of Science and Technology (MOST104-2314-B-010-055-MY3,MOST105-2633-B-075-002), the Research Foundation for Cardiovascular Medicine (105-02-022), Szu-yuan Research Foundation of Internal Medicine (107-041), and National Health Research Institutes (NHRIEX107-10513SC, NHRI-EX106-10513SC). Publisher Copyright: {\textcopyright} 2018",
year = "2019",
month = mar,
day = "1",
doi = "10.1016/j.amjcard.2018.11.046",
language = "English",
volume = "123",
pages = "782--786",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "5",
}