TY - JOUR
TI - Anticoagulation for atrial fibrillation in active cancer
AU - Farmakis, Dimitrios
AU - Papakotoulas, Pavlos
AU - Angelopoulou, Eleni and
AU - Bischiniotis, Theodoros
AU - Giannakoulas, George
AU - Kliridis,
AU - Panagiotis
AU - Richter, Dimitrios
AU - Paraskevaidis, Ioannis
JO - Oncology Letters
PY - 2022
VL - 23
TODO - 4
SP - null
PB - SPANDIDOS PUBL LTD
SN - 1792-1074, 1792-1082
TODO - 10.3892/ol.2022.13244
TODO - cancer; atrial fibrillation; anticoagulation; low molecular weight
heparins; direct oral anticoagulants
TODO - Atrial fibrillation (AF) may often pre-exist in patients with newly
diagnosed cancer or occur with increased frequency shortly after cancer
diagnosis. Patients with active cancer and AF have a particularly high
risk of thromboembolic complications, as both conditions carry a risk of
thrombosis. Thromboembolic risk is determined by several factors,
including advanced age, sex (females), cancer histology
(adenocarcinomas), location (e.g., pancreas, stomach), advanced stage,
anticancer regimens (e.g., platinum compounds, anti-angiogenic
therapies, immune modulators), comorbidities (e.g., obesity, kidney
disease) and concurrent therapies (e.g., surgery, central catheters).
Physicians are often reluctant to prescribe anticoagulants to patients
with active cancer and AF, mainly due to fear of bleeding complications,
which is partly related to the paucity of evidence in the field.
Decision making regarding anticoagulation for the prevention of ischemic
stroke and systemic embolism in patients with active cancer and AF may
be challenging and should not simply rely on the risk prediction scores
used in the general AF population. By contrast, the administration and
choice of anticoagulants should be based on the comprehensive,
individualized and periodic evaluation of thromboembolic and bleeding
risk, drug-drug interactions, patient preferences and access to
therapies.
ER -