Bleeding with oral anticoagulant dabigatran is highly associated with occult cancers in atrial fibrillation patients

Future Cardiol. 2018 Jan;14(1):27-36. doi: 10.2217/fca-2017-0063. Epub 2017 Dec 4.

Abstract

Aim: The aim of this study was to examine cancer and bleeding in atrial fibrillation patients administered with dabigatran.

Materials & methods: This study enrolled 509 consecutive nonvalvular atrial fibrillation patients who received dabigatran. The mean administration period was 14.8 ± 15.7 months. We investigated the prevalence and new development of cancers. Further, the relation between cancer and adverse events was evaluated.

Results: In the 509 patients, major bleeding occurred in 2.6% and dyspepsia in 8.4%. Further, 16.9% patients had a history of cancer and 3.9% developed new cancers. These adverse events developed in 45% patients who developed new cancers. The cancer (hazard ratio: 6.30; p = 0.003) was a significant predictor of major bleeding.

Conclusion: Bleeding was associated with the presence of cancer.

Keywords: bleeding; dabigatran; direct oral anticoagulant; gastrointestinal cancers; atrial fibrillation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Antithrombins / administration & dosage
  • Antithrombins / adverse effects
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / drug therapy
  • Dabigatran / administration & dosage
  • Dabigatran / adverse effects*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / chemically induced*
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Neoplasms / complications*
  • Gastrointestinal Neoplasms / epidemiology
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasms, Unknown Primary / complications*
  • Neoplasms, Unknown Primary / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Stroke / complications
  • Stroke / prevention & control*
  • Survival Rate / trends

Substances

  • Antithrombins
  • Dabigatran