Cardiovascular impact of cancer in patients with atrial fibrillation on warfarin: a systematic review and meta-analysis
Oliveira, Gustavo; Pasqualotto, Eric; Balieiro, Caroline; Nienkötter, Thiago; Silva, Ana Laura Soares; Carvalho, Henrique Champs Porfírio; Minucci, Barbara Silvestre; Cintra, Júlia; Kabariti, Júlia; Zapparoli, Isabella; Borges, Maria Eduarda Stacciarini; Moreira, Maria Eduarda Liporaci; Assunção, Marcela; Maluf, Pâmela; Guida, Camila Mota.
J. Am. Coll. Cardiol
; 83(13 Suppl. A)Apr. 2024. tab.
Artículo
en Inglés
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1551902
BACKGROUND:
The impact of cancer on patients with atrial fibrillation (AF) on warfarin remains a topic of ongoing debate.METHODS:
We performed a systematic review and meta-analysis exploring the effect of cancer in patients with AF on warfarin. We searched PubMed, Embase, and Cochrane for eligible trials. Random-effects model was used to calculate the risk ratios (RRs), with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3.RESULTS:
Five trials comprising 90,572 patients were included, of whom 12,239 (13.5%) had a personal history of cancer. The patient population had an average age of 72.7 years and 59.6% were male. A history of cancer was associated with a significant increase in any bleeding (RR 1.33; 95% CI 1.15- 1.53; p<0.01). There were no significant differences between groups for stroke (RR 1.05; 95% CI 0.86- 1.29; p=0.61), major bleeding (RR 1.44; 95% CI 0.95-2.18; p=0.09), cardiovascular (CV) death (RR 0.91; 95% CI 0.59-1.41; p=0.67), myocardial infarction (MI) (RR 1.42; 95% CI 0.96-2.10; p=0.08), gastrointestinal (GI) bleeding (RR 1.74; 95% CI 0.77-3.92; p=0.18), or all-cause death (RR 1.57; 95% CI 0.99-2.49; p=0.06).CONCLUSION:
Among patients with AF on warfarin, a history of cancer is associated with an increased risk of any bleeding, with no significant effect on stroke, major bleeding, CV death, MI, GI bleeding, and all-cause death.
Biblioteca responsable:
BR79.1
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