PMID- 25174259
OWN - NLM
STAT- MEDLINE
DCOM- 20150713
LR  - 20151119
IS  - 1365-2060 (Electronic)
IS  - 0785-3890 (Linking)
VI  - 46
IP  - 8
DP  - 2014 Dec
TI  - Anticoagulant-related gastrointestinal bleeding--could this facilitate early 
      detection of benign or malignant gastrointestinal lesions?
PG  - 672-8
LID - 10.3109/07853890.2014.952327 [doi]
AB  - INTRODUCTION: The higher incidence of gastrointestinal (GI) bleeding with the 
      non-vitamin K oral anticoagulants (NOACs) may be related to pre-existing 
      malignancies; diagnostic measures triggered by these bleedings could lead to 
      early detection of these malignancies. METHODS: We retrieved the preferred terms 
      on GI bleeding and GI cancer reported as adverse events (AEs) from phase III 
      studies in patients with atrial fibrillation for each NOAC on ClinicalTrials.gov 
      . We also analyzed the RE-LY trial database. RESULTS: From ClinicalTrials.gov , 
      AE-GI bleeding incidence was: dabigatran 110 mg b.i.d. (D110: 1.42% versus 
      1.37%), dabigatran 150 mg b.i.d. (D150: 1.93% versus 1.37%), rivaroxaban (3.52% 
      versus 2.68%), and apixaban (1.93% versus 1.59%), compared with warfarin, 
      respectively. The incidence of AE-GI cancer was similar between the NOACs (D110 
      [0.79%], D150 [0.61%], rivaroxaban [0.83%], and apixaban [0.69%]), but 
      numerically higher compared with warfarin (0.37%; 0.73%; 0.57%, respectively). In 
      the RE-LY database, the same pattern was seen for dabigatran, with an association 
      between GI bleeding and GI cancer diagnosis. CONCLUSION: Anticoagulant-related GI 
      bleeding may represent the unmasking of pre-existing malignancies leading to 
      increased detection of GI cancer. This may be especially in the first month of 
      treatment and could explain the numerically higher numbers of GI malignancies 
      observed with NOACs.
FAU - Clemens, Andreas
AU  - Clemens A
AD  - Center for Thrombosis and Hemostasis, University Medical Center , Mainz , 
      Germany.
FAU - Strack, Andreas
AU  - Strack A
FAU - Noack, Herbert
AU  - Noack H
FAU - Konstantinides, Stavros
AU  - Konstantinides S
FAU - Brueckmann, Martina
AU  - Brueckmann M
FAU - Lip, Gregory Y H
AU  - Lip GY
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140831
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
RN  - 0 (Anticoagulants)
RN  - 0 (Benzimidazoles)
RN  - 0 (Morpholines)
RN  - 0 (Pyrazoles)
RN  - 0 (Pyridones)
RN  - 0 (Thiophenes)
RN  - 11P2JDE17B (beta-Alanine)
RN  - 3Z9Y7UWC1J (apixaban)
RN  - 5Q7ZVV76EI (Warfarin)
RN  - 9NDF7JZ4M3 (Rivaroxaban)
RN  - I0VM4M70GC (Dabigatran)
SB  - IM
MH  - Anticoagulants/*adverse effects
MH  - Atrial Fibrillation/drug therapy
MH  - Benzimidazoles/administration & dosage/adverse effects
MH  - Clinical Trials, Phase III as Topic
MH  - Dabigatran
MH  - Early Detection of Cancer
MH  - Gastrointestinal Hemorrhage/*epidemiology/*etiology
MH  - Gastrointestinal Neoplasms/complications/*diagnosis/*epidemiology
MH  - Humans
MH  - Incidence
MH  - Morpholines/adverse effects
MH  - Pyrazoles/adverse effects
MH  - Pyridones/adverse effects
MH  - Retrospective Studies
MH  - Rivaroxaban
MH  - Thiophenes/adverse effects
MH  - Warfarin/adverse effects
MH  - beta-Alanine/administration & dosage/adverse effects/analogs & derivatives
OTO - NOTNLM
OT  - Anticoagulants
OT  - gastrointestinal hemorrhage
OT  - gastrointestinal neoplasms
OT  - non-vitamin K oral anticoagulants
EDAT- 2014/09/02 06:00
MHDA- 2015/07/15 06:00
CRDT- 2014/09/02 06:00
PHST- 2014/09/02 06:00 [entrez]
PHST- 2014/09/02 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
AID - 10.3109/07853890.2014.952327 [doi]
PST - ppublish
SO  - Ann Med. 2014 Dec;46(8):672-8. doi: 10.3109/07853890.2014.952327. Epub 2014 Aug 
      31.