Abstract
BACKGROUND
Oral anticoagulant treatments (OATs) are used in patients with atrial fibrillation (AF) to prevent complications. However, continuous treatment with OATs during chemotherapy in AF patients with cancer is controversial due to increased bleeding concerns. Thus, we aimed to evaluate whether OAT treatment decreased the risk of cardiogenic thromboembolism in those patients.
METHODS
We conducted a retrospective cohort study using a Japanese administrative database including patients with AF aged ≥18 years who underwent chemotherapy between 2008 and 2017 and had used OATs before starting chemotherapy. We divided patients into two groups; continuous users and discontinuous users of OATs within 90 days after starting chemotherapy. We calculated the incidence of cardiogenic thromboembolism. Also, we estimated the hazard ratio (HR) and 95% confidence intervals (CIs) of it using Cox proportional hazards models, including matched propensity scores (PSs), to adjust for comorbidities.
RESULTS
Of a total 6,542 patients in the study cohort, 4,916 (75.1%) patients continued OAT treatment (mean age, 76.2 years; 75.9% male) and 1,596 (24.9%) patients discontinued OAT treatment (mean age, 76.2 years; 76.6% male). PS matching created a cohort of 1,596 matched pairs. The incidence of cardiogenic thromboembolism among the continuation group and the discontinuation group were 11.18 and 16.97 per 1,000 person-years, respectively. Adjusted HR was not different in the two groups (0.65, 95% CI: 0.39–1.07).
CONCLUSIONS
Prescription of OATs at least once within 90 days after initiating chemotherapy in AF patients with cancer was not significantly associated with the incidence of cardiogenic thromboembolism.
