De Luca, L.; Camilli, M.; Canale, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Turazza, F.M.; Gabrielli, D.; Bisceglia, I. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Cancers2023, 15, 5357.
De Luca, L.; Camilli, M.; Canale, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Turazza, F.M.; Gabrielli, D.; Bisceglia, I. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Cancers 2023, 15, 5357.
De Luca, L.; Camilli, M.; Canale, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Turazza, F.M.; Gabrielli, D.; Bisceglia, I. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Cancers2023, 15, 5357.
De Luca, L.; Camilli, M.; Canale, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Turazza, F.M.; Gabrielli, D.; Bisceglia, I. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Cancers 2023, 15, 5357.
Abstract
Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with can-cer. Indeed, cancer patients have a significantly higher incidence of AF than that ob-served in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume AF as a marker for occult cancer screen-ing, especially in older adults. The pathophysiological mechanisms are many and var-ied, including the underlying pro-inflammatory state, specific treatments (chemo and radiotherapy) and surgery. The therapeutic management of patients with cancer and AF involves the same rhythm and frequency control strategies as the general popula-tion; however, the numerous interactions with chemotherapeutics, which lead to a sig-nificant increase in side effects, as well as the extreme fragility of the patient should be considered. Anticoagulant therapy is also a complex challenge to address, as bleeding and stroke risk scores have not been fully assessed in this subpopulation. Furthermore, in large studies establishing the efficacy of direct oral anticoagulants (DOACs), cancer patients have been underrepresented. In this review, we elaborate on mechanisms linking AF to cancer patients with a particular focus on therapeutic challenges in this population.
Keywords
atrial fibrillation; management; cardio-oncology
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
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