Open Access

Anticoagulation for atrial fibrillation in active cancer (Review)

  • Authors:
    • Dimitrios Farmakis
    • Pavlos Papakotoulas
    • Eleni Angelopoulou
    • Theodoros Bischiniotis
    • George Giannakoulas
    • Panagiotis Kliridis
    • Dimitrios Richter
    • Ioannis Paraskevaidis
  • View Affiliations

  • Published online on: February 17, 2022     https://doi.org/10.3892/ol.2022.13244
  • Article Number: 124
  • Copyright: © Farmakis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

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.
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April-2022
Volume 23 Issue 4

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Spandidos Publications style
Farmakis D, Papakotoulas P, Angelopoulou E, Bischiniotis T, Giannakoulas G, Kliridis P, Richter D and Paraskevaidis I: Anticoagulation for atrial fibrillation in active cancer (Review). Oncol Lett 23: 124, 2022.
APA
Farmakis, D., Papakotoulas, P., Angelopoulou, E., Bischiniotis, T., Giannakoulas, G., Kliridis, P. ... Paraskevaidis, I. (2022). Anticoagulation for atrial fibrillation in active cancer (Review). Oncology Letters, 23, 124. https://doi.org/10.3892/ol.2022.13244
MLA
Farmakis, D., Papakotoulas, P., Angelopoulou, E., Bischiniotis, T., Giannakoulas, G., Kliridis, P., Richter, D., Paraskevaidis, I."Anticoagulation for atrial fibrillation in active cancer (Review)". Oncology Letters 23.4 (2022): 124.
Chicago
Farmakis, D., Papakotoulas, P., Angelopoulou, E., Bischiniotis, T., Giannakoulas, G., Kliridis, P., Richter, D., Paraskevaidis, I."Anticoagulation for atrial fibrillation in active cancer (Review)". Oncology Letters 23, no. 4 (2022): 124. https://doi.org/10.3892/ol.2022.13244