Cancer and atrial fibrillation: Epidemiology, mechanisms, and anticoagulation treatment

Prog Cardiovasc Dis. 2021 May-Jun:66:28-36. doi: 10.1016/j.pcad.2021.04.004. Epub 2021 Apr 26.

Abstract

Cancer patients are at an increased risk of developing atrial fibrillation (AF) and thrombosis. However, the management of anticoagulation in patients with both diseases may be challenging, and data on these patients are lacking. We summarize the current evidence on the incidence and prevalence of cancer in AF and vice versa and provide some practical considerations on the management of oral anticoagulation in specific clinical situations. Low-molecular weight heparins are not approved for thromboprophylaxis in AF, and management of warfarin can be difficult. The use of direct oral anticoagulants may be particularly attractive for their rapid onset/offset action and lower bleeding risk.

Keywords: Atrial fibrillation; Cancer; Chemotherapy; DOACs; Oral anticoagulants; Radiotherapy.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / epidemiology
  • Hemorrhage / chemically induced
  • Humans
  • Incidence
  • Neoplasms / diagnosis
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / prevention & control*
  • Thrombosis / diagnosis
  • Thrombosis / epidemiology
  • Thrombosis / prevention & control*
  • Treatment Outcome

Substances

  • Anticoagulants