Effect of Cancer on Clinical Outcomes in Elderly Patients With Non-Valvular Atrial Fibrillation ― Substudy of the ANAFIE Registry -

Takanori Ikeda, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Yukihiro Koretsune, Ken Okumura, Wataru Shimizu, Hiroyuki Tsutsui, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Satoshi Teramukai, Tetsuya Kimura, Jumpei Kaburagi, Atsushi Takita, Hiroshi Inoue

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Data on outcomes for patients with atrial fibrillation (AF) and active cancer are scarce. The effect of active cancer on thrombosis and bleeding risks in elderly (≥75 years) patients with non-valvular AF (NVAF) enrolled in the All Nippon AF In the Elderly (ANAFIE) Registry were prospectively analyzed. Methods and Results: In this subanalysis of the ANAFIE Registry, a prospective, multicenter, observational study conducted in Japan, we compared the incidence rates of clinical outcomes between active cancer and non-cancer groups. Relationships between primary outcomes and anticoagulation status were evaluated. Of the 32,725 patients enrolled in the Registry, 3,569 had active cancer at baseline; 92.0% of active cancer patients received anticoagulants (23.7%, warfarin; 68.2%, direct oral anticoagulants [DOACs]). Two-year probabilities of stroke/systemic embolic events (SEE) were similar in the cancer (3.33%) and non-cancer (3.16%) groups. Patients with cancer had greater incidences of major bleeding (2.86% vs. 2.04%), all-cause death (10.95% vs. 6.77%), and net clinical outcomes (14.63% vs. 10.00%) than those without cancer. In patients without cancer, DOACs were associated with a decreased risk of stroke/SEE, major bleeding, all-cause death, and net clinical outcome compared with warfarin. No between-treatment differences were observed in patients with active cancer. Conclusions: Active cancer had no effect on stroke/SEE incidence in elderly NVAF patients, but those with cancer had higher incidences of major bleeding events and all-cause death than those without cancer.

Original languageEnglish
Pages (from-to)202-210
Number of pages9
JournalCirculation Journal
Issue number2
Publication statusPublished - 2022

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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