Relationships, Current Issues, Safety and Efficacy of Oral Anticoagulation in Cancer Patients with Atrial Fibrillation
Articolo
Data di Pubblicazione:
2023
Citazione:
Relationships, Current Issues, Safety and Efficacy of Oral Anticoagulation in Cancer Patients with Atrial Fibrillation / A. Franchina, M. Rocchetti, E. Sala, A. Laricchia, A. Minardi, A. Spangaro, M. Guazzi, S. Lucreziotti, A. Cereda. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:20(2023 Oct 16), pp. 6559.1-6559.18. [10.3390/jcm12206559]
Abstract:
A relationship between malignancy and impaired hemostasis has been proven, and balancing clotting and bleeding risks can be challenging. Half of cancer patients with atrial fibrillation (AF) do not receive any oral anticoagulation (OAC). Using PubMed on the relationship between cancer and AF and their association with hemostasis, targeting studies comparing vitamin K antagonists (VKAs) and direct OAC (DOAC) strategies in AF cancer patients, three RCTs (>3000 patients) and eight observational studies (>250,000 patients) comparing different OACs were retrieved. The VKA prescribed was always warfarin. Dabigatran was the only DOAC not analyzed in the RCTs but the most used in non-randomized studies, whereas edoxaban-treated patients were the majority in the RCTs. Overall, the DOAC patients showed similar or lower rates of efficacy (thromboembolic) and safety (bleeding) outcomes compared to the VKA patients. DOACs are subject to fewer interactions with antineoplastic agents. DOACs may be preferable to VKAs as a thromboembolic prophylaxis in cancer patients with non-valvular AF.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
atrial fibrillation; bleeding; cancer; direct oral anticoagulants; ischemic stroke; systemic embolism; vitamin K antagonists (VKAs);
Elenco autori:
A. Franchina, M. Rocchetti, E. Sala, A. Laricchia, A. Minardi, A. Spangaro, M. Guazzi, S. Lucreziotti, A. Cereda
Link alla scheda completa: