Observational studyJournal of the American Heart Association2020
New Cancer Diagnosis After Bleeding in Anticoagulated Patients With Atrial Fibrillation.
Observational study in Journal of the American Heart Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Cardio-Oncology: A Myriad of Relationships Between Cardiovascular Disease and Cancer.Frontiers in cardiovascular medicine · 2022Pooled it
- Anticoagulation-associated hemorrhage in atrial fibrillation as a marker of occult malignancy: a narrative review.Thrombosis journal · 2026Review
- Prevalence, Incidence, and Impact of Cancer in Atrial Fibrillation: A Systematic Review and Meta-Analysis of 70,000,000 Patients.Health science reports · 2026Review
- Hemoglobin Decline and Occult Cancer After OAC Initiation: "No Smoke Without Fire?"JACC. CardioOncology · 2026Article
- Hemoglobin Decline After Oral Anticoagulation Initiation and Subsequent Cancer Detection in Patients With Atrial Fibrillation.JACC. CardioOncology · 2026Article
- Rising burden of cancer and atrial fibrillation-related mortality among adults in the United States, 1999-2019.Heart rhythm O2 · 2025Article
- Atrial Fibrillation and Cancer-Epidemiology, Mechanisms, and Management.Journal of clinical medicine · 2024Review
- Anticoagulant-related bleeding as a sign of underlying tumoural lesions in patients with atrial fibrillation: a nationwide cohort study.European heart journal open · 2024Article
- Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study.European heart journal · 2024Article
- Direct factor Xa inhibitors and the risk of cancer and cancer mortality: A Danish population-based cohort study.PLoS medicine · 2024Article
- Cardio-oncology rehabilitation: are we ready?European heart journal supplements : journal of the European Society of Cardiology · 2024Article
- Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies.Frontiers in oncology · 2024Article
- Association Between Bleeding and New Cancer Detection and the Prognosis in Patients With Myocardial Infarction.Journal of the American Heart Association · 2022Article
- Incidence and Predictors of Clinically Significant Bleedings after Transcatheter Left Atrial Appendage Closure.International journal of environmental research and public health · 2022Article
- Associations of anemia with death and major bleeding in patients with atrial fibrillation: A report from the Chinese Atrial Fibrillation Registry Study.Clinical cardiology · 2022Article
- Rivaroxaban in acute venous thromboembolism: UK prescribing experience.Research and practice in thrombosis and haemostasis · 2021Article
- Risk of More Advanced Lesions at Hysterectomy after Initial Diagnosis of Non-Atypical Endometrial Hyperplasia in Patients with Postmenopausal Bleeding and Oral Anticoagulant Treatment.Medicina (Kaunas, Lithuania) · 2021Article
- A new classification of cardio-oncology syndromes.Cardio-oncology (London, England) · 2021Review
- New Cancer Diagnosis After Bleeding in Anticoagulated Patients With Atrial Fibrillation.Journal of the American Heart Association · 2020Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Bleeding is frequent in patients with atrial fibrillation (AF) treated with oral anticoagulant therapy, and may be the first manifestation of underlying cancer. We sought to investigate to what extent bleeding represents the unmasking of an occult cancer in patients with AF treated with oral anticoagulants. Methods and Results Using data from CardioCHUVI-AF (Retrospective Observational Registry of Patients With Atrial Fibrillation From Vigo's Health Area), 8753 patients with AF aged ≥75 years with a diagnosis of AF between 2014 and 2017 were analyzed. Of them, 2171 (24.8%) experienced any clinically relevant bleeding, and 479 (5.5%) were diagnosed with cancer during a follow-up of 3 years. Among 2171 patients who experienced bleeding, 198 (9.1%) were subsequently diagnosed with cancer. Patients with bleeding have a 3-fold higher hazard of being subsequently diagnosed with new cancer compared with those without bleeding (4.7 versus 1.4 per 100 patient-years; adjusted hazard ratio [HR], 3.2 [95% CI, 2.6-3.9]). Gastrointestinal bleeding was associated with a 13-fold higher hazard of new gastrointestinal cancer diagnosis (HR, 13.4; 95% CI, 9.1-19.8); genitourinary bleeding was associated with an 18-fold higher hazard of new genitourinary cancer diagnosis (HR, 18.1; 95% CI, 12.5-26.2); and bronchopulmonary bleeding was associated with a 15-fold higher hazard of new bronchopulmonary cancer diagnosis (HR, 15.8; 95% CI, 6.0-41.3). For other bleeding (nongastrointestinal, nongenitourinary, nonbronchopulmonary), the HR for cancer was 2.3 (95% CI, 1.5-3.6). Conclusions In patients with AF treated with oral anticoagulant therapy, any gastrointestinal, genitourinary, or bronchopulmonary bleeding was associated with higher rates of new cancer diagnosis. These bleeding events should prompt investigation for cancers at those sites.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.