Outcomes by Class of Anticoagulant Use for Nonvalvular Atrial Fibrillation in Patients With Active Cancer

Potter, Adam S.; Patel, Ashley; Khawaja, Muzamil; Chen, Christopher; Zheng, Henry; Kaczmarek, Jessica; Gao, Feng; Karimzad, Kaveh; Song, Juhee; Koutroumpakis, Efstratios; Khalaf, Shaden; Iliescu, Cezar; Deswal, Anita; Palaskas, Nicolas

doi:10.1016/j.jaccao.2022.07.004

Cited by 12 publications

(10 citation statements)

References 28 publications

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“…Post-hoc analyses of pivotal trials involving DOACS in AF, together with large observational studies suggest that the DOACs are safer and at least equally efficacious than VKAs in individuals with AF and active malignancy [ 121 , 122 , 123 ]. Patients with a previous diagnosis of cancer were poorly represented in the ROCKET AF trial (640 out of 14,264) [ 124 ].…”

Section: Doacs In Patients With Atrial Fibrillation and Malignancymentioning

confidence: 99%

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Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Lucà,

Oliva,

Abrignani

et al. 2023

JCM

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It is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH). In addition, many factors, such as fewer pharmacokinetic interactions and less need for monitoring, contribute to the favor of this therapeutic strategy. Although DOACs represent a more suitable option, several issues should be considered in clinical practice, including drug–drug interactions (DDIs), switching to other antithrombotic therapies, preprocedural and postprocedural periods, and the use in patients with chronic renal and liver failure and in those with cancer. Furthermore, adherence to DOACs appears to remain suboptimal. This narrative review aims to provide a practical guide for DOAC prescription and address challenging scenarios.

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Section: Doacs In Patients With Atrial Fibrillation and Malignancymentioning

confidence: 99%

“…A recent single-institution retrospective analysis including 1133 AF patients with malignancy, showed no differences in terms of CVA, GI bleeding, and intracranial hemorrhage (IH) when they were treated with DOACs instead of warfarin [ 122 ].…”

Section: Doacs In Patients With Atrial Fibrillation and Malignancymentioning

confidence: 99%

Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Lucà,

Oliva,

Abrignani

et al. 2023

JCM

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Section: Observational Studies and Registry-based Data On The Compari...mentioning

confidence: 99%

“…Table 2 summarizes results from eight population-based cohort studies comparing the safety and efficacy of DOAC vs. VKA in more than 250,000 patients with non-valvular AF and cancer [49][50][51][52][53][54][55][56]. The largest study included 196,521 patients [50], while the smallest included 224 patients [54]. Five studies did not include edoxaban [49][50][51]54,55], and consequently, it was the least represented DOAC among these cohort studies, while the most represented was apixaban (Figure 2).…”

Section: Observational Studies and Registry-based Data On The Compari...mentioning

confidence: 99%

“…The largest study included 196,521 patients [50], while the smallest included 224 patients [54]. Five studies did not include edoxaban [49][50][51]54,55], and consequently, it was the least represented DOAC among these cohort studies, while the most represented was apixaban (Figure 2). Four authors performed a propensity score (PS) matched analysis paring warfarin patients with similar DOAC patients [51,52,54,55].…”

Section: Observational Studies and Registry-based Data On The Compari...mentioning

confidence: 99%

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Relationships, Current Issues, Safety and Efficacy of Oral Anticoagulation in Cancer Patients with Atrial Fibrillation

Franchina,

Rocchetti,

Sala

et al. 2023

JCM

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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.

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When anticoagulation management in atrial fibrillation becomes difficult: Focus on chronic kidney disease, coagulation disorders, and cancer

Papakonstantinou,

Kalogera,

Charitos

et al. 2024

Blood Reviews

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Outcomes by Class of Anticoagulant Use for Nonvalvular Atrial Fibrillation in Patients With Active Cancer

Cited by 12 publications

References 28 publications

Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Relationships, Current Issues, Safety and Efficacy of Oral Anticoagulation in Cancer Patients with Atrial Fibrillation

When anticoagulation management in atrial fibrillation becomes difficult: Focus on chronic kidney disease, coagulation disorders, and cancer

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