Evidence map›Paper›PMID 39967202›Full record

ArticleJACC. CardioOncology2025

The Association of Malignancy With Stroke and Bleeding in Atrial Fibrillation: A Population-Based Cohort Study.

Malak El-Rayes, Mohamed Adam, Jiming Fang, Xuesong Wang, Irene Jeong, Peter C Austin, Andrew C T Ha, Michael G Fradley, Thomas A Boyle, Eitan Amir and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. CardioOncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Malak El-RayesDivision of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Centre intégré de santé et de services sociaux de Laval, Hôpital Cité de la Santé, Laval, Quebec, Canada; Department of Medicine, Université de Montréal, Montréal, QC, Canada; The Ted Rogers Program in Cardiotoxicity Prevention, Toronto, Ontario, Canada.
Mohamed AdamWomen's College Hospital, Toronto, Ontario, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jiming FangICES, Toronto, Ontario, Canada.
Xuesong WangICES, Toronto, Ontario, Canada.
Irene JeongICES, Toronto, Ontario, Canada.
Peter C AustinICES, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Andrew C T HaDivision of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.
Michael G FradleyPerelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Thomas A BoylePerelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Eitan AmirDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Paaladinesh ThavendiranathanDivision of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; The Ted Rogers Program in Cardiotoxicity Prevention, Toronto, Ontario, Canada.
Husam Abdel-QadirDivision of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; The Ted Rogers Program in Cardiotoxicity Prevention, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address: h.abdel.qadir@utoronto.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is undetermined if malignancy independently increases stroke risk in atrial fibrillation (AF).

objectivesThis study sought to determine the association of malignancy with stroke and bleeding in AF.

methodsPopulation-based cohort study using administrative datasets of people aged ≥66 years with newly diagnosed AF. People diagnosed with malignancy within 5 years before AF diagnosis were matched to cancer-free control subjects on age, sex, AF diagnosis details, CHA

resultsAmong 199,710 AF patients, 24,991 (12.5%) people had prior malignancy. Malignancy was associated with more inpatient diagnoses of AF (vs outpatient) and less anticoagulation. We matched 43,802 people with AF (21,901 with malignancy, mean age 78.1 years; 59.5% male). After adjusting for anticoagulation status, malignancy had a similar hazard of stroke (HR: 1.01; 95% CI: 0.88-1.15) but higher hazard of bleeding (HR: 1.45; 95% CI: 1.37-1.53) compared with cancer-free control subjects in the matched sample. Analyses of cancer subgroups with comparison to matched control subjects mostly showed consistent results, except for: 1) increased hazard of stroke in lung cancer; and 2) lack of increased bleeding hazard in breast cancer and lymphoma.

conclusionsPeople with AF and malignancy generally had similar hazards of stroke but higher hazards of bleeding compared with cancer-free control subjects, suggesting that malignancy should not lower the threshold for anticoagulation in AF.

Indexed as

anticoagulationarrhythmiaATRIAatrial fibrillationbleedingcancercerebrovascular diseaseCHA(2)DS(2)-VASc scoreepidemiologystrokethrombosis

Identifiers

PMID39967202
PMCPMC11866432

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.