Cardiovascular impact of cancer in patients with atrial fibrillation on direct oral anticoagulants: a systematic review and meta-analysis
J. Am. Coll. Cardiol
; 83(13 Suppl. A)Apr. 2024. tab.
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1551927
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
The impact of cancer on patients with atrial fibrillation (AF) on direct oral anticoagulants (DOACs) remains a matter of debate.METHODS:
We conducted a systematic review and meta-analysis exploring the effect of personal history of cancer in patients with AF on DOACs. PubMed, Embase, and Cochrane databases were searched for relevant studies. We used the random-effects model to calculate the risk ratio (RR) and 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3.RESULTS:
A total of six studies were included, with 63,177 patients. The mean age was 74.0 years. In this population of individuals who had AF and took DOACs, a history of cancer was associated with a significant increase in major bleeding (RR 1.72; 95% CI 1.24-2.38; p<0.01), gastrointestinal (GI) bleeding (RR 2.11; 95% CI 1.25-3.57; p<0.01), and any bleeding (RR 1.54; 95% CI 1.39-1.70; p<0.01). Additionally, all-cause death was significantly higher in patients with AF and a history of cancer (RR 1.93; 95% CI 1.35-2.76; p<0.01). There was no significant difference between groups in stroke (RR 1.77; 95% CI 0.66-4.73; p=0.25), cardiovascular (CV) death (RR 0.84; 95% CI 0.57-1.23; p=0.36), or myocardial infarction (MI) (RR 1.21; 95% CI 0.82-1.79; p=0.34).CONCLUSION:
Our findings suggest that major bleeding, GI bleeding, any bleeding, and all-cause mortality significantly increased in patients with AF on DOACs who have a personal history of cancer, as compared with those who do not.
Full text:
Available
Collection:
National databases
/
Brazil
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Atrial Fibrillation
/
Factor Xa Inhibitors
/
Neoplasms
Language:
English
Journal:
J. Am. Coll. Cardiol
Year:
2024
Document type:
Article
/
Congress and conference
Institution/Affiliation country:
Instituto Dante Pazzanese de Cardiologia/BR