[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-354618-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-354618-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","hemoglobin-decline-after-oral-anticoagulation-initiation-and-subsequent-cancer-detection-in-patients-with-atrial-fibrillation","Hemoglobin Decline After Oral Anticoagulation Initiation and Subsequent Cancer Detection in Patients With Atrial Fibrillation","","Background studies of cancer risk during oral anticoagulation (OAC) emphasize overt bleeding, leaving the prognostic meaning of hemoglobin (Hb) decline without clinically overt bleeding unclear. This study evaluates whether Hb decrease after OAC initiation, in atrial fibrillation patients, predicts subsequent cancer risk. Using linked Korean insurance data with serial examinations, Hb change was assessed in 6,789 patients, excluding prior cancer, overt bleeding, and early OAC discontinuation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/hemoglobin-decline-after-oral-anticoagulation-initiation-and-subsequent-cancer-detection-in-patients-with-atrial-fibrillation/354618/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/hemoglobin-decline-after-oral-anticoagulation-initiation-and-subsequent-cancer-detection-in-patients-with-atrial-fibrillation/354618.png","ImageObject",300,407,{"name":42,"@type":43},"OmBimo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-09-22",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What question does this study address about oral anticoagulation and cancer risk?","Question",{"text":63,"@type":64},"It evaluates whether hemoglobin (Hb) decline after starting oral anticoagulation, when no clinically overt bleeding occurs, is associated with later cancer risk in patients with atrial fibrillation.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were patients selected and how was Hb decline defined?",{"text":68,"@type":64},"Patients with atrial fibrillation from a linked Korean National Health Insurance Service database had two examinations within one year before and after OAC initiation. Prior cancer, end-stage renal disease, overt bleeding, or early OAC discontinuation were excluded, and patients were classified by Hb change: Hb decrease ≥2 g/dL versus no significant decrease.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the key outcomes and main findings?",{"text":72,"@type":64},"The primary outcome was incident cancer, with secondary outcomes including site-specific cancers, all-cause mortality, thromboembolic events, and bleeding outcomes. Over a median 10.6 months follow-up, Hb decline ≥2 g/dL was associated with higher overall cancer incidence, particularly gastrointestinal cancers, and increased all-cause mortality and major bleeding.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},354618,1790165689,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},962090893581,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","J A C C : C A R D I O O N C O L O GY V O L . 8 , N O . 4 , 2 0 2 6  \nª 2 0 2 6 T H E A U T H O R S . P U B L I S H E D BY E L S E V I E R O N B E H A L F O F T H E A M E R I C A N  \nC O L L E G E O F C A R D I O L O GY F O U N D A T I O N . T H I S I S A N O P E N A C C E S S A R T I C L E U N D E RT H E C C B Y-N C-N D L I C E N S E ( [h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y-n c-n d / 4 . 0 /](h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y-n c-n d / 4 . 0 /) ) .  \nORIGINAL RESEARCH  \nHemoglobin Decline After  \nOral Anticoagulation Initiation and Subsequent Cancer Detection in Patients With Atrial Fibrillation  \nPil-Sung Yang, MD,a, * Jee Hyuk Byun, MD,b,* Hanjin Park, MD,c Daehoon Kim, MD,c Dongseon Kang, MD,d Young Shin Lee, MD,e Min Kim, MD,f Hong-Ju Kim, MD,g Han-Joon Bae, MD,h Jung-Hoon Sung, MD,i,† Boyoung Joung, MDc,†  \nABSTRACT  \nBACKGROUND Previous studies evaluating cancer risk during oral anticoagulation (OAC) have focused on overt bleeding events, whereas the significance of hemoglobin (Hb) decline in the absence of clinically overt bleeding events after OAC initiation has not been evaluated.  \nOBJECTIVES The purpose of this study was to evaluate the association between Hb decline after OAC initiation in the absence of clinically overt bleeding events and subsequent cancer risk in patients with atrial fibrillation (AF) .  \nMETHODS Using the Korean National Health Insurance Service database linked to serial health examinations, 6,789 patients with AF were identified who underwent 2 examinations within 1 year before and after OAC initiation. Patients with prior cancer, end-stage renal disease, overt bleeding, or early OAC discontinuation were excluded. Patients were classified by Hb change (Hb decrease $2 g/dL vs no significant decrease) . The primary outcome was incident cancer; secondary outcomes included site-specific cancers, all-cause mortality, thromboembolic events, and bleeding outcomes.  \nRESULTS During a median follow-up period of 10.6 months, patients with Hb decreases $2 g/dL had a higher incidence of overall cancer than those without (6 .7 vs 4.3 per 100 person-years; adjusted HR: 1.42; 95% CI: 1.10-1.97) . The association was particularly evident for gastrointestinal cancers (adjusted HR: 1.78; 95% CI: 1.12-2.83) . Cancer risk associated with Hb declines was greater in older patients, those with chronic kidney disease, and those receiving antiplatelet therapy (P for interaction \u003C 0. 05) . Hb decline was also associated with higher all-cause mortality and major bleeding, with no differences in stroke.  \nCONCLUSIONS In patients with AF initiating OAC, Hb decline $2 g/dL in the absence of clinically overt bleeding events is associated with increased cancer risk, particularly gastrointestinal malignancy, and higher mortality.  \n(JACC CardioOncol. 2026;8:378–391) © 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)) .  \nFrom the aDivision of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; bDepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA; cDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; dDivision of Cardiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea; eDivision of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea; fDivision of Cardiology, Department of Internal Medicine, Kangbuk  \nISSN 2666-0873 [https://doi.org/10.1016/j.jaccao.2026","cbCailoqTDiqeYOT","https://ap.wps.com/l/cbCailoqTDiqeYOT","pdf",1642670,14,"English","# Abstract\n## Background\n## Objectives\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What question does this study address about oral anticoagulation and cancer risk?\",\"answer\":\"It evaluates whether hemoglobin (Hb) decline after starting oral anticoagulation, when no clinically overt bleeding occurs, is associated with later cancer risk in patients with atrial fibrillation.\"},{\"question\":\"How were patients selected and how was Hb decline defined?\",\"answer\":\"Patients with atrial fibrillation from a linked Korean National Health Insurance Service database had two examinations within one year before and after OAC initiation. Prior cancer, end-stage renal disease, overt bleeding, or early OAC discontinuation were excluded, and patients were classified by Hb change: Hb decrease ≥2 g/dL versus no significant decrease.\"},{\"question\":\"What were the key outcomes and main findings?\",\"answer\":\"The primary outcome was incident cancer, with secondary outcomes including site-specific cancers, all-cause mortality, thromboembolic events, and bleeding outcomes. Over a median 10.6 months follow-up, Hb decline ≥2 g/dL was associated with higher overall cancer incidence, particularly gastrointestinal cancers, and increased all-cause mortality and major bleeding.\"}]","Hemoglobin Decline After Oral Anticoagulation Initiation and Subsequent Cancer Detection in Patients With Atrial Fibrillation | PDF",1790112584,35]