title: Potential Effect of Antiplatelet and Anticoagulant Therapy on the Timing of the Diagnosis of Bladder Cancer.
abstract: BACKGROUND
  The most common presenting symptom of bladder cancer (BCa) is hematuria. The present study was designed to define whether patients taking antiplatelet and/or anticoagulant drugs might experience hematuria at an earlier stage or grade of BCa.
  
  
  METHODS
  The data from 1532 consecutive patients who presented to the emergency unit of our institute from 2004 to 2012 because of gross hematuria as a single symptom were evaluated. Patients (n = 227) with a further diagnosis of BCa were included in our study. For the purpose of the present study, patients were divided into 2 groups: patients receiving antiplatelet or anticoagulant therapy (AAT) (group 1) and patients not receiving AAT (group 2) at the moment of the macroscopic hematuria episode. The effect of AAT on the pathologic stage and grade of BCa was statistically assessed using univariate and multivariate logistic regression analysis.
  
  
  RESULTS
  A total of 59 (26%) and 168 (74%) patients were included in groups 1 and 2, respectively. On multivariate logistic regression analysis, ATT conferred a protective effect against both pathologic stage ≥ T2 (odds ratio [OR], 0.37; 95% confidential interval [CI], 0.12-0.66; P = .01) and higher grade (OR, 0.56; 95% CI, 0.26-0.85; P = .02) at tumor presentation.
  
  
  CONCLUSIONS
  According to the results of the present retrospective investigation, patients who received AAT seem to experience gross hematuria significantly earlier than do untreated patients, resulting in the chance of an earlier diagnosis and treatment of bladder cancer.
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy; Doctorate Research Program, Magna Graecia University of Catanzaro, Catanzaro, Italy; Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: marco.moschini87@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschini
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Department of Urology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Pellucchi
authors.affiliation: Department of Urology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rocchini
authors.affiliation: Doctorate Research Program, Magna Graecia University of Catanzaro, Catanzaro, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.affiliation: Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Serretta
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D055088:Early Detection of Cancer; D005260:Female; D006417:Hematuria / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Anticoagulant; Antiplatelet; Bladder cancer; Emergency room; Hematuria; Non-muscle invasive bladder cancer