Tsung-Lin Yang1, Yu-Feng Hu2, Yenn-Jiang Lin2, Shih-Lin Chang2, Li-Wei Lo2, Ta-Chuan Tuan2, Tze-Fan Chao2, Fa-Po Chung2, Hao-Jan Lei3, Shih-Ann Chen4. 1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine and the Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC. 3. Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. 4. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine and the Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: epsachen@ms41.hinet.net.
Abstract
BACKGROUND: It is unclear whether atrial fibrillation (AF) adversely influences the clinical course of patients with hepatocellular carcinoma (HCC). METHODS: During the period from January 1, 2001 to December 31, 2010, 476 patients (mean ± SD age 60.3 ± 12.9 years) diagnosed with HCC were retrospectively enrolled in our study. The HCC stage, treatment, baseline characteristics, underlying cardiovascular diseases, and corresponding drug treatment were systematically reviewed. The primary endpoint was death from any cause. RESULTS: AF was associated with a significantly reduced survival time in patients with HCC (AF vs. non-AF patients mean ± SD survival time 470.1 ± 89.6 days vs. 1161.2 ± 32.6 days, log-rank p < 0.001; probability of survival 0.20, 95% confidence interval 0.10-0.38, p < 0.001). After adjustment for sex and age, AF was still associated with poorer survival times (hazard ratio 4.131, 95% confidence interval 2.134-5.733, p < 0.001). The causes of death among 22 patients with both HCC and AF included 11 cases of hepatic failure, four cases of ruptured tumor, and two cases of bleeding from esophageal varices. None of these patients with AF used warfarin. Seven bleeding events related to HCC were noted, but none of these patients developed a major thromboembolism. The mean ± SD follow-up period was 645 ± 468 days. CONCLUSION: Patients with HCC had a significantly reduced survival time with the comorbidity of AF. Tumor rupture was relatively common among patients with both HCC and AF. The anticoagulation treatment of AF in patients with HCC deviated from the current guidelines without an increase in thromboembolic events.
BACKGROUND: It is unclear whether atrial fibrillation (AF) adversely influences the clinical course of patients with hepatocellular carcinoma (HCC). METHODS: During the period from January 1, 2001 to December 31, 2010, 476 patients (mean ± SD age 60.3 ± 12.9 years) diagnosed with HCC were retrospectively enrolled in our study. The HCC stage, treatment, baseline characteristics, underlying cardiovascular diseases, and corresponding drug treatment were systematically reviewed. The primary endpoint was death from any cause. RESULTS:AF was associated with a significantly reduced survival time in patients with HCC (AF vs. non-AFpatients mean ± SD survival time 470.1 ± 89.6 days vs. 1161.2 ± 32.6 days, log-rank p < 0.001; probability of survival 0.20, 95% confidence interval 0.10-0.38, p < 0.001). After adjustment for sex and age, AF was still associated with poorer survival times (hazard ratio 4.131, 95% confidence interval 2.134-5.733, p < 0.001). The causes of death among 22 patients with both HCC and AF included 11 cases of hepatic failure, four cases of ruptured tumor, and two cases of bleeding from esophageal varices. None of these patients with AF used warfarin. Seven bleeding events related to HCC were noted, but none of these patients developed a major thromboembolism. The mean ± SD follow-up period was 645 ± 468 days. CONCLUSION:Patients with HCC had a significantly reduced survival time with the comorbidity of AF. Tumor rupture was relatively common among patients with both HCC and AF. The anticoagulation treatment of AF in patients with HCC deviated from the current guidelines without an increase in thromboembolic events.
Authors: Ming Yuan; Zhiwei Zhang; Gary Tse; Xiaojin Feng; Panagiotis Korantzopoulos; Konstantinos P Letsas; Bryan P Yan; William K K Wu; Huilai Zhang; Guangping Li; Tong Liu; Yunlong Xia Journal: Cardiol Res Pract Date: 2019-04-14 Impact factor: 1.866
Authors: Nachiket Apte; Parinita Dherange; Usman Mustafa; Lina Ya'qoub; Desiree Dawson; Kathleen Higginbotham; Marjan Boerma; Daniel P Morin; Dipti Gupta; Jerry McLarty; Richard Mansour; Paari Dominic Journal: Front Cardiovasc Med Date: 2021-01-22