Anticoagulation in cancer patients with atrial fibrillation and grade 3-4 thrombocytopenia.

Atrial fibrillation or flutter (AF) is prevalent in cancer patients. Many of these patients have an indication for anticoagulation (AC) but are also at risk for developing chemotherapy-induced thrombocytopenia. There are scarce data regarding management of AC and risk of bleeding and thrombosis in cancer patients with AF and thrombocytopenia. To assess anticoagulation management and incidence of bleeding and arterial thromboembolism (ATE) in cancer patients with AF and grade 3-4 thrombocytopenia (platelets <50 × 10 A retrospective cohort study included adults with active cancer, grade 3-4 thrombocytopenia and AF with CHA The cohort included 131 patients; 90 in the No-AC group and 41 in the Continue-AC group. Patient characteristics were balanced between the groups. The 30-day cumulative incidence of ATE was 2 % [95 % CI 0.4 %-7 %] in the No-AC group and 2 % [0.2 %-11 %] in the Continue-AC group (HR 0.92 [95 % CI 0.09-9.88]). The 30-day cumulative incidence of major bleeding was 7.8 % [95 % CI 3.40 %-14.52 %] and 2.44 % [95 % CI 0.18 %-11.22 %] in the No-AC and Continue-AC groups, respectively (HR 3.29 [95 % CI 0.42-26.04]). The high rate of bleeding and low rate of ATE in thrombocytopenic cancer patients with AF suggests that holding AC during time-limited periods may be a reasonable approach.

Informations de copyright

Copyright © 2024 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Galia Spectre is consultant to Pfizer, Bayer, Boehringer Ingelheim, Sanofi, Novartis and Medison; is on the scientific advisory board of Pfizer, Bayer, Sanofi, Medison and Neopharm; and is a stockholder in NA. Anat Gafter-Gvili is consultant to Bayer, Pfizer and Sanofi and is on the scientific advisory board of Pfizer, Bayer, Sanofi and BI. Pia Raanani is consultant to Pfizer, Novartis and BMS; is on the advisory board of Pfizer; is on the speaker's bureau of Pfizer and Janssen; and has received research support from Pfizer and Novartis. Avi Leader served on advisory board of Pfizer, Bayer, Sanofi, Leo Pharma and Novartis. Genady Drozdinsky, Noam Arad and Itamar Poran declare they have no financial or non-financial interests.