Bleeding and New Cancer Diagnosis in Patients With Atherosclerosis
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu klinické zkoušky, časopisecké články, práce podpořená grantem
- Klíčová slova
- aspirin, hemorrhage, neoplasms, rivaroxaban,
- MeSH
- Aspirin terapeutické užití MeSH
- ateroskleróza komplikace farmakoterapie MeSH
- cévní mozková příhoda farmakoterapie MeSH
- gastrointestinální krvácení chemicky indukované MeSH
- infarkt myokardu farmakoterapie MeSH
- inhibitory agregace trombocytů terapeutické užití MeSH
- kombinovaná farmakoterapie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory komplikace diagnóza farmakoterapie MeSH
- nemoci koronárních tepen farmakoterapie MeSH
- onemocnění periferních arterií farmakoterapie MeSH
- rivaroxaban terapeutické užití MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- Aspirin MeSH
- inhibitory agregace trombocytů MeSH
- rivaroxaban MeSH
BACKGROUND: Patients treated with antithrombotic drugs are at risk of bleeding. Bleeding may be the first manifestation of underlying cancer. METHODS: We examined new cancers diagnosed in relation to gastrointestinal or genitourinary bleeding among patients enrolled in the COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies) and determined the hazard of new cancer diagnosis after bleeding at these sites. RESULTS: Of 27 395 patients enrolled (mean age, 68 years; women, 21%), 2678 (9.8%) experienced any (major or minor) bleeding, 713 (2.6%) experienced major bleeding, and 1084 (4.0%) were diagnosed with cancer during a mean follow-up of 23 months. Among 2678 who experienced bleeding, 257 (9.9%) were subsequently diagnosed with cancer. Gastrointestinal bleeding was associated with a 20-fold higher hazard of new gastrointestinal cancer diagnosis (7.4% versus 0.5%; hazard ratio [HR], 20.6 [95% CI, 15.2-27.8]) and 1.7-fold higher hazard of new nongastrointestinal cancer diagnosis (3.8% versus 3.1%; HR, 1.70 [95% CI, 1.20-2.40]). Genitourinary bleeding was associated with a 32-fold higher hazard of new genitourinary cancer diagnosis (15.8% versus 0.8%; HR, 32.5 [95% CI, 24.7-42.9]), and urinary bleeding was associated with a 98-fold higher hazard of new urinary cancer diagnosis (14.2% versus 0.2%; HR, 98.5; 95% CI, 68.0-142.7). Nongastrointestinal, nongenitourinary bleeding was associated with a 3-fold higher hazard of nongastrointestinal, nongenitourinary cancers (4.4% versus 1.9%; HR, 3.02 [95% CI, 2.32-3.91]). CONCLUSIONS: In patients with atherosclerosis treated with antithrombotic drugs, any gastrointestinal or genitourinary bleeding was associated with higher rates of new cancer diagnosis. Any gastrointestinal or genitourinary bleeding should prompt investigation for cancers at these sites. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01776424.
Amphia Ziekenhuis and WCN Utrecht the Netherlands
ANMCO Research Center Florence Italy
Brigham and Women's Hospital Heart and Vascular Center Harvard Medical School Boston MA
Centre for Cardiovascular Science University of Edinburgh United Kingdom
Department of Cardiology Dupuytren University Hospital Limoges France
Department of Medicine Solna Karolinska Institutet Stockholm Sweden
Facultad de Ciencias de la Salud Eugenio Espejo Universidad UTE Quito Ecuador
FuWai Hospital CAMS and PUMC Beijing China
Hospital Alemão Oswaldo Cruz São Paulo Brazil
Population Health Research Institute McMaster University and Hamilton Health Sciences Ontario Canada
School of Rehabilitation Science McMaster University Hamilton Ontario Canada
Citace poskytuje Crossref.org
ClinicalTrials.gov
NCT01776424
