JAHA:抗凝房颤患者出血后新发癌症诊断分析

2020-11-03 MedSci原创 MedSci原创

在接受口服抗凝治疗的AF患者中,任何胃肠道、泌尿生殖道或支气管肺部出血与新发癌症的诊断率升高有关。这些出血事件应促使对这些部位的癌症进行筛查。

口服抗凝治疗的房颤患者经常出现出血,这可能是潜在癌症的首发表现。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员试图探究出血在多大程度上是口服抗凝剂治疗的房颤患者隐匿性癌症的首发症状。

研究人员使用维哥健康地区房颤患者的回顾性观察登记中心(CardioCHUVI‐AF)的数据,分析了2014年至2017年之间8753例年龄≥75岁的AF患者。

该研究中有2171名(24.8%)患者经历了任何与临床相关的出血,并且在3年的随访中,有479名(5.5%)患者被诊断出癌症。在2171名经历过出血的患者中,有198名(9.1%)随后被诊断出患有癌症。与没有出血的患者相比,出血患者随后被诊断出新发癌症的风险要高出3倍(每100个患者每年4.7人和1.4人;校正后的风险比[HR]为3.2 [95%CI为2.6-3.9])。胃肠道出血与新发胃肠道癌诊断的风险增加13倍(HR为13.4;95%CI为9.1-19.8)相关;泌尿生殖系统出血与新发泌尿生殖系统癌症诊断的风险增加18倍(HR为18.1;95%CI为12.5-26.2)相关;支气管出血与新发支气管肺癌的风险增加15倍(HR为15.8;95%CI为6.0-41.3)相关。对于其他出血(胃肠道、非泌尿生殖道、非支气管肺)和癌症的HR为2.3(95%CI为1.5-3.6)。

由此可见,在接受口服抗凝治疗的AF患者中,任何胃肠道、泌尿生殖道或支气管肺部出血与新发癌症的诊断率升高有关。这些出血事件应促使对这些部位的癌症进行筛查

原始出处:

Sergio Raposeiras Roubín.et al.New Cancer Diagnosis After Bleeding in Anticoagulated Patients With Atrial Fibrillation.J AM HEART ASSOC.2020.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.016836

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    2020-11-05 zhaohui6731
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    2020-11-04 心介

    房颤,临床上碰到很多哦

    0

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