| アブストラクト | BACKGROUND: The association between cancer and stroke or bleeding outcomes in atrial fibrillation is unclear. We sought to examine how certain types of cancer influence the balance between stroke and bleeding risk in patients with nonvalvular atrial fibrillation (NVAF). METHODS AND RESULTS: We estimated stroke and bleeding risk among adult patients with NVAF and certain types of cancer (breast, prostate, colorectal, lung, and hematological cancer) from 2009 to 2019 based on data from the UK Clinical Practice Research Datalink GOLD and Aurum databases. The control group included patients with NVAF only. Of 177 065 patients with NVAF, 11379 (6.4%) had cancer (1691 breast, 3955 prostate, 1666 colorectal, 2491 hematological, and 1576 lung). Compared with patients without cancer, stroke risk was higher in patients with breast cancer (adjusted hazard ratio [aHR], 1.20 [95% CI, 1.07-1.35) and with prostate cancer (aHR, 1.11 [95% CI, 1.01-1.12) if diagnosed within 6 months before NVAF. The risk of bleeding was increased in subjects with hematological cancer (aHR, 1.55 [95% CI, 1.40-1.71]), lung cancer (aHR, 1.49 [95% CI, 1.25, 1.77]), prostate cancer (aHR, 1.38 [95% CI, 1.28-1.49]), and colorectal cancer (aHR, 1.36 [95% CI, 1.21-1.53]), but not for subjects with breast cancer. The more recent the cancer diagnosis before NVAF diagnosis (within 6 months), the higher the risk of bleeding. CONCLUSIONS: Breast and prostate cancer are associated with increased stroke risk, whereas in some cancer types, the risk of bleeding seemed to exceed stroke risk. In these patients, prescribing of oral anticoagulant should be carefully evaluated to balance bleeding and stroke risk. |
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| ジャーナル名 | Journal of the American Heart Association |
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| 投稿日 | 2023/9/26 |
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| 投稿者 | Ajabnoor, Alyaa M; Parisi, Rosa; Zghebi, Salwa S; Ashcroft, Darren M; Faivre-Finn, Corinne; Morris, Charlotte; Mamas, Mamas A; Kontopantelis, Evangelos |
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| 組織名 | Department of Pharmacy Practice, Faculty of Pharmacy King Abdulaziz University;Jeddah Saudi Arabia.;Division of Informatics, Imaging and Data Sciences, School of Health Sciences,;Faculty of Biology, Medicine and Health, Manchester Academic Health Science;Centre (MAHSC) University of Manchester Manchester United Kingdom.;Division of Population Health, Health Services Research and Primary Care, School;of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic;Health Science Centre (MAHSC) University of Manchester Manchester United Kingdom.;Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health;University of Manchester Manchester United Kingdom.;National Institute for Health and Care Research (NIHR) Greater Manchester Patient;Safety Research Collaboration (PSRC) University of Manchester Manchester United;Kingdom.;The Christie NHS Foundation Trust and The University of Manchester Manchester;United Kingdom.;Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for;Primary Care and Health Sciences Keele University Keele United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37750567/ |
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