癌症对具有房颤（AF）的患者的抗凝治疗的连续性构成挑战，例如通过与癌症相关的手术或并发症。我们旨在提供有关癌症患者的AF患者中中断和停药抗凝治疗的发生率和原因的数据，并评估其对血栓栓塞（TE）和重度出血（MB）风险的贡献。本回顾性研究确定了2012年至2017年间两家医院的癌症患者中的AF患者。在两年的随访期间收集了关于抗凝治疗、TE和MB的数据。获得了在抗凝治疗期间和之后中断和停药，以及永久停药后发生的TE和MB的发生率（每100患者年）和调整危险比（aHR）。共确定了1213名患有癌症的AF患者，其中140名患者永久停药，426名患者经历了一次或多次中断。中断或停药抗凝最常见的原因是癌症相关治疗（n = 441, 62％），出血（n = 129, 18％）或临终关怀（n = 36, 5％）。在中断期间和恢复后，TE的风险最高，IR分别为19（14-25）和105（64-13），aHR分别为3.1（1.9-5.0）和4.6（2.4-9.0）。在中断期间和恢复后的首30天内，重度出血风险不仅增加，而且IR分别为33（12-72）和30（17-48），aHR分别为3.3（1.1-9.8）和2.4（1.2-4.6）。中断抗凝治疗在患有癌症的AF患者中存在高风险的TE和MB。高发病率要求有针对癌症环境量身定制的更好（围手术期）抗凝治疗管理策略。版权所有© 2023年作者。由Elsevier Ltd.出版。保留所有权利。

Cancer provides challenges to the continuity of anticoagulant treatment in patients with atrial fibrillation (AF), e.g. through cancer-related surgery or complications. We aimed to provide data on the incidence and reasons for interrupting and discontinuing anticoagulant treatment in AF patients with cancer and to assess its contribution to the risk of thromboembolism (TE) and major bleeding (MB).This retrospective study identified AF patients with cancer in two hospitals between 2012 and 2017. Data on anticoagulant treatment, TE and MB were collected during two-year follow-up. Incidence rates (IR) per 100 patient-years and adjusted hazard ratios (aHR) were obtained for TE and MB occurring during on- and off-anticoagulant treatment, during interruption and after resumption, and after permanent discontinuation.1213 AF patients with cancer were identified, of which 140 patients permanently discontinued anticoagulants and 426 patients experienced one or more interruptions. Anticoagulation was most often interrupted or discontinued due to cancer-related treatment (n = 441, 62 %), bleeding (n = 129, 18 %) or end of life (n = 36, 5 %). The risk of TE was highest off-anticoagulation and during interruptions, with IRs of 19 (14-25)) and 105 (64-13), and aHRs of 3.1 (1.9-5.0) and 4.6 (2.4-9.0), respectively. Major bleeding risk were not only increased during an interruption, but also in the first 30 days after resumption, with IRs of 33 (12-72) and 30 (17-48), and aHRs of 3.3 (1.1-9.8) and 2.4 (1.2-4.6), respectively.Interruption of anticoagulation therapy harbors high TE and MB risk in AF patients with cancer. The high incidence rates call for better (periprocedural) anticoagulant management strategies tailored to the cancer setting.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.