Bleeding and New Cancer Diagnosis in Patients with Atherosclerosis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F19%3AN0000059" target="_blank" >RIV/00064173:_____/19:N0000059 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11120/19:43918746

Výsledek na webu

<a href="https://doi.org/10.1161/CIRCULATIONAHA.119.041949" target="_blank" >https://doi.org/10.1161/CIRCULATIONAHA.119.041949</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/CIRCULATIONAHA.119.041949" target="_blank" >10.1161/CIRCULATIONAHA.119.041949</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Bleeding and New Cancer Diagnosis in Patients with Atherosclerosis

Popis výsledku v původním jazyce

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 Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial, and determined the hazard of new cancer diagnosis after bleeding at these sites. Results: Of 27,395 patients enrolled (mean age 68, women 21%), 2,678 (9.8%) experienced any (major or minor) bleeding, 713 (2.6%) experienced major bleeding, and 1,084 (4.0%) were diagnosed with cancer, during a mean follow-up of 23 months. Among 2,678 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% confidence interval [CI]: 15.2-27.8), and 1.7-fold higher hazard of new non-gastrointestinal 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). Non-gastrointestinal, non-genitourinary bleeding was associated with a 3-fold higher hazard of non-gastrointestinal, non-genitourinary 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.

Název v anglickém jazyce

Bleeding and New Cancer Diagnosis in Patients with Atherosclerosis

Popis výsledku anglicky

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 Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial, and determined the hazard of new cancer diagnosis after bleeding at these sites. Results: Of 27,395 patients enrolled (mean age 68, women 21%), 2,678 (9.8%) experienced any (major or minor) bleeding, 713 (2.6%) experienced major bleeding, and 1,084 (4.0%) were diagnosed with cancer, during a mean follow-up of 23 months. Among 2,678 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% confidence interval [CI]: 15.2-27.8), and 1.7-fold higher hazard of new non-gastrointestinal 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). Non-gastrointestinal, non-genitourinary bleeding was associated with a 3-fold higher hazard of non-gastrointestinal, non-genitourinary 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Circulation

ISSN

0009-7322

e-ISSN

1524-4539

Svazek periodika

140

Číslo periodika v rámci svazku

18

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

1451-1459

Kód UT WoS článku

000493073500008

EID výsledku v databázi Scopus

2-s2.0-85073968029