Table 9.

Summary of ‘malignancy’ as a risk factor for bleeding in AF patients receiving OACs

Study	Subjects (n)	Type of OACs	Definition	Main findings	HR (95% CI)	P value
Fang et al., 2011	9186	VKA	Any diagnosis of cancer	Prevalence of diagnosed cancer in patients with or without major bleeding: 18.0% vs. 15.1%	HR 1.7 (1.3–2.2)	<0.001
O'Brien et al., 2015	7411	VKA/dabigatran	History of cancer	The rate of major bleeding was 23.3% in patients without cancer vs. 30.8% in those with cancer.	NR	<0.0001
Melloni et al., 2017	9749	VKA/dabigatran	Any diagnosis of cancer	The rate of major bleeding was 3.45 per 100 patient-years in patients without cancer vs. 5.13 per 100 patient-years in those with cancer.	HR 1.21 (1.04–1.40)	0.02
Vedovati et al., 2018	2288	Dabigatran Rivaroxaban Apixaban	Patients with active cancer, at time of inclusion in the study, in presence of a diagnosis of cancer or any anti-cancer treatment within 6 months before the study inclusion, or recurrent locally advanced or metastatic cancer; patients with history of cancer	The higher bleeding risk found in cancer compared to non-cancer patients was mainly due to an excess of bleeding at GI and at genitourinary sites.	HR 2.58 (1.08–6.16)	0.033

AF, atrial fibrillation; GI, gastrointestinal; HR, hazard ratio; NR, not reported; OACs, oral anticoagulants; VKA, vitamin K antagonists.