Περίληψη:
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.
Συγγραφείς:
Farmakis, Dimitrios
Papakotoulas, Pavlos
Angelopoulou, Eleni and
Bischiniotis, Theodoros
Giannakoulas, George
Kliridis,
Panagiotis
Richter, Dimitrios
Paraskevaidis, Ioannis
