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Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer
BACKGROUND: Based on their renal excretion, direct oral anticoagulants (DOACs) may increase the risk of hematuria in patients with atrial fibrillation (AF) and urologic cancer compared with vitamin K antagonists. OBJECTIVES: To examine the risk of bleeding associated with DOAC versus warfarin in pat...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756162/ https://www.ncbi.nlm.nih.gov/pubmed/35059549 http://dx.doi.org/10.1002/rth2.12629 |
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author | Ording, Anne Gulbech Søgaard, Mette Skjøth, Flemming Grove, Erik Lerkevang Lip, Gregory Y. H. Larsen, Torben Bjerregaard Nielsen, Peter Brønnum |
author_facet | Ording, Anne Gulbech Søgaard, Mette Skjøth, Flemming Grove, Erik Lerkevang Lip, Gregory Y. H. Larsen, Torben Bjerregaard Nielsen, Peter Brønnum |
author_sort | Ording, Anne Gulbech |
collection | PubMed |
description | BACKGROUND: Based on their renal excretion, direct oral anticoagulants (DOACs) may increase the risk of hematuria in patients with atrial fibrillation (AF) and urologic cancer compared with vitamin K antagonists. OBJECTIVES: To examine the risk of bleeding associated with DOAC versus warfarin in patients with AF and urologic cancer. METHODS: We conducted a Danish nationwide cohort study with individually linked registry data on patients with AF and active or a history of urologic cancer. We calculated crude rates per 100 person‐years of hospital episodes of major bleeding and hematuria. We then compared rates of hematuria during the year after initial oral anticoagulation filled prescription by treatment regimen using inverse probability of treatment weighting and Cox regression. RESULTS: The study population included 2615 patients with AF and urologic cancer (6.1% women; median age, 76 years) initiating a DOAC or warfarin. One‐year risk of hematuria was 4.8% in the DOAC group and 4.7% in the warfarin group with a corresponding weighted hazard ratio (HR) of 1.21 (95% confidence interval [CI], 0.81‐1.81). HRs for hematuria were generally similar in analyses restricted to patients treated with standard‐dose DOAC and patients with active cancer. For those with cancer of the kidney, renal pelvis, ureter, and bladder, the HR was 0.82 (95% CI, 0.44‐1.54). Results were mirrored for other bleeding events, whereas the risk for intracranial bleeding was lower with DOACs. CONCLUSION: In patients with AF and urologic cancer, there was a similar risk of hematuria associated with DOAC and warfarin treatment. |
format | Online Article Text |
id | pubmed-8756162 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87561622022-01-19 Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer Ording, Anne Gulbech Søgaard, Mette Skjøth, Flemming Grove, Erik Lerkevang Lip, Gregory Y. H. Larsen, Torben Bjerregaard Nielsen, Peter Brønnum Res Pract Thromb Haemost Brief Reports BACKGROUND: Based on their renal excretion, direct oral anticoagulants (DOACs) may increase the risk of hematuria in patients with atrial fibrillation (AF) and urologic cancer compared with vitamin K antagonists. OBJECTIVES: To examine the risk of bleeding associated with DOAC versus warfarin in patients with AF and urologic cancer. METHODS: We conducted a Danish nationwide cohort study with individually linked registry data on patients with AF and active or a history of urologic cancer. We calculated crude rates per 100 person‐years of hospital episodes of major bleeding and hematuria. We then compared rates of hematuria during the year after initial oral anticoagulation filled prescription by treatment regimen using inverse probability of treatment weighting and Cox regression. RESULTS: The study population included 2615 patients with AF and urologic cancer (6.1% women; median age, 76 years) initiating a DOAC or warfarin. One‐year risk of hematuria was 4.8% in the DOAC group and 4.7% in the warfarin group with a corresponding weighted hazard ratio (HR) of 1.21 (95% confidence interval [CI], 0.81‐1.81). HRs for hematuria were generally similar in analyses restricted to patients treated with standard‐dose DOAC and patients with active cancer. For those with cancer of the kidney, renal pelvis, ureter, and bladder, the HR was 0.82 (95% CI, 0.44‐1.54). Results were mirrored for other bleeding events, whereas the risk for intracranial bleeding was lower with DOACs. CONCLUSION: In patients with AF and urologic cancer, there was a similar risk of hematuria associated with DOAC and warfarin treatment. John Wiley and Sons Inc. 2022-01-13 /pmc/articles/PMC8756162/ /pubmed/35059549 http://dx.doi.org/10.1002/rth2.12629 Text en © 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Brief Reports Ording, Anne Gulbech Søgaard, Mette Skjøth, Flemming Grove, Erik Lerkevang Lip, Gregory Y. H. Larsen, Torben Bjerregaard Nielsen, Peter Brønnum Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title | Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title_full | Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title_fullStr | Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title_full_unstemmed | Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title_short | Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
title_sort | hematuria in anticoagulated patients with atrial fibrillation and urologic cancer |
topic | Brief Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756162/ https://www.ncbi.nlm.nih.gov/pubmed/35059549 http://dx.doi.org/10.1002/rth2.12629 |
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