Eur Heart J:抗凝治疗房颤患者胃肠道出血与结直肠癌风险

2020-02-09 xing.T MedSci原创

由此可见,在接受抗凝治疗的AF患者中,胃肠道出血导致发生结直肠癌的绝对风险升高。GI出血不应作为OAC治疗的良性结局而排除,而应始终评估潜在的恶性病因。

口服抗凝(OAC)治疗的房颤(AF)患者经常发生肠道(GI)出血。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员试图调查GI出血在多大程度上是隐匿性直肠癌的预警信息。

研究人员通过丹麦行政登记中心确定了125418例接受OAC治疗的AF患者,使用非参数估计和半参数绝对风险回归来估计有和没有GI出血患者大肠癌的绝对风险。

在长达3年的随访中,研究人员确定了2576例GI出血的患者,其中140例患者在GI出血的第一年内被诊断为大肠癌。在所有年龄组中,研究人员观察到GI出血后大肠癌的风险升高。小于65岁和76-80岁年龄组的患者1年绝对风险分别为3.7%[95%置信区间(CI)为2.2-6.2]至8.1%(95%CI为6.1-10.6)。比较有和没有GI出血的患者时,研究人员发现所有年龄组的直肠癌风险比均增加,最年轻组小于65岁和最年老组超过85岁的风险比分别为24.2(95%CI为14.5-40.4)和12.3(95%CI为7.9-19.0) 。

由此可见,在接受抗凝治疗的AF患者中,肠道出血导致发生结直肠癌的绝对风险升高。GI出血不应作为OAC治疗的良性结局而排除,而应始终评估潜在的恶性病因。

原始出处:

Casey Crump.et al.Gastrointestinal bleeding and the risk of colorectal cancer in anticoagulated patients with atrial fibrillation.Eur Heart J.2020.https://doi.org/10.1093/eurheartj/ehz964

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    2020-02-11 zhaojie88
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2061909, encodeId=8626206190988, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Mar 09 21:40:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705364, encodeId=adcc1e05364f6, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Sun Aug 09 03:40:00 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346308, encodeId=1f69134630866, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357390, encodeId=0595135e39028, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390980, encodeId=b9b113909809a, content=<a href='/topic/show?id=6e618332871' target=_blank style='color:#2F92EE;'>#胃肠道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83328, encryptionId=6e618332871, topicName=胃肠道出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6a2500070, createdName=124987a0m66(暂无昵称), createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453346, encodeId=548c145334681, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563223, encodeId=3eb6156322353, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614539, encodeId=4f96161453975, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031224, encodeId=fc7810312245d, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Sun Feb 09 17:40:00 CST 2020, time=2020-02-09, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2061909, encodeId=8626206190988, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Mon Mar 09 21:40:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705364, encodeId=adcc1e05364f6, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Sun Aug 09 03:40:00 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346308, encodeId=1f69134630866, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357390, encodeId=0595135e39028, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1390980, encodeId=b9b113909809a, content=<a href='/topic/show?id=6e618332871' target=_blank style='color:#2F92EE;'>#胃肠道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83328, encryptionId=6e618332871, topicName=胃肠道出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6a2500070, createdName=124987a0m66(暂无昵称), createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453346, encodeId=548c145334681, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563223, encodeId=3eb6156322353, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1614539, encodeId=4f96161453975, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Tue Feb 11 05:40:00 CST 2020, time=2020-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031224, encodeId=fc7810312245d, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Sun Feb 09 17:40:00 CST 2020, time=2020-02-09, status=1, ipAttribution=)]
    2020-02-11 slcumt
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    2020-02-09 心介

    房颤,临床上碰到很多哦

    0

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