title: Clinical Significance of Hematuria in Atrial Fibrillation With Oral Anticoagulation Therapy.
abstract: Hematuria is a common and important complication in atrial fibrillation (AF) patients on oral anticoagulation therapy (OAT). This study evaluated the clinical significance of hematuria and its relationship with genitourinary disease in AF patients receiving OAT.
  
  
  
  Among 20,456 consecutive AF patients who visited a tertiary hospital from January 2005 to April 2015, 5,833 had hematuria. Of these 5,833 patients, 3,798 were on OAT (OAT(+) group) and 2,035 were not (OAT(-) group). A total of 1,785 patients from each group were then matched on propensity score analysis. The prevalence of cancer and other diseases in the genitourinary tract was evaluated. While there was no difference in the prevalence of genitourinary stones or urinary tract infection, genitourinary cancer was significantly more common in the OAT(+) group than in the OAT(-) group (1.6% vs. 0.7%, P=0.011). Bladder cancer was the most common genitourinary malignancy, and it was significantly more common in the OAT(+) group (1.2% vs. 0.5%, P=0.019). Subjects on warfarin were more likely to have bladder cancers of lower pathologic grade (63.6% vs. 33.3%, P=0.124).
  
  
  
  OAT was associated with a higher prevalence and early detection of genitourinary cancer in AF patients with hematuria. Meticulous evaluation of the cause of hematuria is necessary in AF patients with hematuria receiving OAT.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
authors.forename: Hee Tae
authors.initials: HT
authors.lastname: Yu
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.forename: Jong-Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006417:Hematuria / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced; D014565:Urogenital Neoplasms / Q000139:chemically induced; D014570:Urologic Diseases / Q000139:chemically induced; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin