Bleeding in patients occurs frequently when treated with oral anticoagulant therapy for atrial fibrillation (AF); this might be the first manifestation of underlying cancer. This study aimed to investigate the extent to which bleeding represents occult cancer’s unmasking in patients with AF treated with oral anticoagulants.
Using data from CardioCHUVI‐AF (Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo’s Health Area), 8753 patients with AF aged greater than or equal to 75 years with a diagnosis of AF between the years 2014-2017 were analyzed. Of them, 24.8% experienced any clinically relevant bleeding, and 5.5% were diagnosed with cancer during a follow‐up of 3 years. Among 2171 patients who experienced bleeding, 9.1% were subsequently diagnosed with cancer. Patients with bleeding have a 3‐fold higher hazard of being later diagnosed with new cancer compared with those without bleeding (4.7 vs. 1.4 per 100 patient‐years).
Among patients with AF treated with OAC therapy, gastrointestinal, genitourinary, and bronchopulmonary bleeding are strongly and relatively associated explicitly with a new cancer diagnosis within the respective organ systems. This association’s strength increases with the severity of bleeding, with most cancers identified within the first six months after the bleeding event. A prompt evaluation of bleeding could be useful for enabling early detection of cancer, primarily gastrointestinal, genitourinary, and bronchopulmonary cancers.
Ref: https://www.ahajournals.org/doi/10.1161/JAHA.120.016836
