Risk of incident genitourinary cancer following hematuria in patients with atrial fibrillation receiving oral anticoagulants.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-11-28 DOI:10.1016/j.hrthm.2024.11.043

Ling Kuo, Yi-Hsin Chan, Jo-Nan Liao, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen, Tze-Fan Chao

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引用次数: 0

Abstract

Background: Hematuria is common in patients with atrial fibrillation (AF) on oral anticoagulants (OACs). However, risks of incident genitourinary (GU) malignancy and detailed etiologies of hematuria have not been well studied.

Objective: We aimed to investigate the risk of hematuria and underlying GU malignancy in patients with AF receiving OACs.

Methods: A total of 192,728 patients with AF receiving OACs were identified from Taiwan National Health Insurance Research Database. The risk of hematuria was compared between patients receiving warfarin (n = 75,541) and non-vitamin K antagonist OACs (NOACs) (n = 117,187). Among them, 18,509 patients experiencing hematuria without previous history of GU malignancy were defined as the study population. One-year risks of GU cancers were studied and compared between warfarin and NOAC users.

Results: Compared with warfarin, NOACs were associated with a higher risk of mild (2.29% per year vs 1.71% per year, adjusted hazard ratio [aHR] 1.107, P < .0001) or moderate hematuria (0.84% per year vs 0.62% per year, aHR 1.075, P = .0189), but a lower risk of severe hematuria (0.15% per year vs 0.17% per year, aHR 0.630, P < .0001). Within 1 year after hematuria, 738 (3.99%) patients were diagnosed with incident GU cancers, and the risk was higher among warfarin compared with NOAC users (4.10% vs 3.89%, odds ratio [OR] 1.1169, P = .041). Age ≥75 years (OR 1.486, P < .0001), male gender (OR 2.342, P < .0001) and abnormal renal function (OR 1.319, P = .0015) were important clinical factors associated with the diagnosis of GU cancer.

Conclusion: GU malignancy occurs in approximately 4% of anticoagulated patients with AF experiencing hematuria. Comprehensive evaluations of underlying etiologies of hematuria are necessary.

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.