Key result
Comorbid cancer linked to ~54% higher CRNM bleeding risk in anticoagulated AF patients.
Why the study?
The bleeding risk associated with long-term oral anticoagulation in patients with atrial fibrillation with cancer compared to those without cancer was unclear.
Does a comorbid diagnosis of cancer increase the risk of bleeding and net composite events in patients with nonvalvular atrial fibrillation on long-term oral anticoagulation?
Cohort (n=5,902)
Yes
Does a comorbid diagnosis of cancer increase the risk of bleeding and net composite events in patients with nonvalvular atrial fibrillation on long-term oral anticoagulation?
Hazard Ratio: 1.54 (95% CI 1.05–2.25)
Absolute Event Rate: 4.4% vs 2.8%
p-value: p=0.002
In patients with nonvalvular atrial fibrillation on long-term oral anticoagulation, a comorbid diagnosis of cancer is associated with a significantly higher risk of clinically relevant nonmajor bleeding and net composite events.
AF with cancer was associated with higher CRNM bleeding on OAC; hypothesis-generating for cancer-specific risk adjustment in prospective studies.
-VASC, and HAS-BLED scores were similar between AF patients with and without cancers. Male population greatly comprised patients with AF with cancers. They were equally prescribed with direct OAC compared to those without cancers. The incidence rate for clinically relevant nonmajor (CRNM) bleeding events was higher in the patients with AF with cancers than in those without cancers (4.4 per 100 person-years versus 2.8 per 100 person-years, P = 0.023), and net composite events were also more frequent in patients with AF with cancers than in those without cancers (6.4 per 100 person-years versus 4.0 per 100 person-years, P = 0.004). Patients with AF with cancers showed a significantly higher rate of CRNM bleeding (hazard ratio [HR] 1.54, confidence interval [CI] 1.05-2.25, P = 0.002) than those without cancers.Based on the AF cohort, AF with cancers could face a significantly higher risk for CRNM bleeding events in the long-term OAC than those without cancers.
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Kang et al. (2023) conducted a cohort in Nonvalvular Atrial Fibrillation (n=5,902). Comorbid cancer vs. Without cancer was evaluated on Clinically relevant nonmajor (CRNM) bleeding events (HR 1.54, 95% CI 1.05-2.25, p=0.002). Patients with atrial fibrillation and comorbid cancer had a significantly higher rate of clinically relevant nonmajor bleeding (HR 1.54) during long-term oral anticoagulation compared to those without cancer.
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