Abstract
Introduction: The presence of hematuria is frequently related with underlying genitourinary pathologies such as urolithiasis or malignancies. Although hematuria is an important and common complication in atrial fibrillation (AF) patients taking oral anticoagulation therapy (OAT), its clinical implication is not fully elucidated. Objectives: We evaluated the clinical significance of hematuria and its relationship with genitourinary disease in patients with AF. Methods: This study included 18,086 consecutive AF patients with (OAT+, n=11,432) or without OAT (OAT-, n=6,654) who visited to a tertiary Hospital from January 2005 to April 2015. The degree of urinary red blood cells (RBC) was reported to range from 0 to 3+ on random urinalyses. The incidence of cancer or stone in the genitourinary tract (kidney, ureter, and bladder) was evaluated. All data were obtained from the Clinical Data Repository System. Results: Overall, 144 (0.8%) patients had malignancies and 164 (0.9%) patients had stones in the genitourinary tract. Hematuria was observed in 3,737 (32.7%) and 2,017 (30.3%) in patients with and without OAT (p=0.001), and the large (≥ urine RBC 3+) hematuria was observed in 1,382 (12.1%) and 666 (10.0%) patients with and without OAT, respectively (p<0.001). While 39 (2.8%) OAT+ patient with large hematuria had malignancies, 8 (1.2%) OAT- patient had (p=0.026). However, if the patients had small hematuria (urine RBC 1+ or 2+), the incidence of genitourinary cancer was not different between OAT+ and OAT- groups (p=0.266). The incidence of genitourinary tract stone in patients with large or small hematuria was comparable between OAT+ and OAT- groups. Conclusions: Large hematuria was associated with higher incidence of cancer in the genitourinary tract in OAT+ group, but not in OAT- group. A meticulous evaluation of the cause of hematuria is needed, if AF patients receiving OAT had large hematuria.
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