Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer
Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with cancer. Indeed, cancer patients have a significantly higher incidence of AF than that observed in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/22/5357 |
| _version_ | 1797459863552393216 |
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| author | Leonardo De Luca Massimiliano Camilli Maria Laura Canale Raffaella Mistrulli Federico Andreoli Guido Giacalone Fabio Maria Turazza Domenico Gabrielli Irma Bisceglia |
| author_facet | Leonardo De Luca Massimiliano Camilli Maria Laura Canale Raffaella Mistrulli Federico Andreoli Guido Giacalone Fabio Maria Turazza Domenico Gabrielli Irma Bisceglia |
| author_sort | Leonardo De Luca |
| collection | DOAJ |
| description | Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with cancer. Indeed, cancer patients have a significantly higher incidence of AF than that observed in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume AF to be a marker for occult cancer screening, especially in older adults. The pathophysiological mechanisms are many and varied, 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 population; however, the numerous interactions with chemotherapeutics, which lead to a significant 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 the mechanisms linking AF to cancer patients with a particular focus on the therapeutic challenges in this population. |
| first_indexed | 2024-03-09T16:57:02Z |
| format | Article |
| id | doaj.art-c85ad621ef564e04b0973922fcbf5b7a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T16:57:02Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c85ad621ef564e04b0973922fcbf5b7a2023-11-24T14:34:05ZengMDPI AGCancers2072-66942023-11-011522535710.3390/cancers15225357Current Data and Future Perspectives on Patients with Atrial Fibrillation and CancerLeonardo De Luca0Massimiliano Camilli1Maria Laura Canale2Raffaella Mistrulli3Federico Andreoli4Guido Giacalone5Fabio Maria Turazza6Domenico Gabrielli7Irma Bisceglia8Department of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00168 Rome, ItalyDivision of Cardiology, Azienda USL Toscana Nord-Ovest, Versilia Hospital, 55041 Lido di Camaiore, ItalyClinical and Molecular Medicine Department, Sapienza University of Rome, 00185 Roma, ItalyClinical and Molecular Medicine Department, Sapienza University of Rome, 00185 Roma, ItalyClinical and Molecular Medicine Department, Sapienza University of Rome, 00185 Roma, ItalyCardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyAtrial fibrillation (AF) is an increasingly recognized comorbidity in patients with cancer. Indeed, cancer patients have a significantly higher incidence of AF than that observed in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume AF to be a marker for occult cancer screening, especially in older adults. The pathophysiological mechanisms are many and varied, 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 population; however, the numerous interactions with chemotherapeutics, which lead to a significant 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 the mechanisms linking AF to cancer patients with a particular focus on the therapeutic challenges in this population.https://www.mdpi.com/2072-6694/15/22/5357atrial fibrillationcanceranticoagulation |
| spellingShingle | Leonardo De Luca Massimiliano Camilli Maria Laura Canale Raffaella Mistrulli Federico Andreoli Guido Giacalone Fabio Maria Turazza Domenico Gabrielli Irma Bisceglia Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer Cancers atrial fibrillation cancer anticoagulation |
| title | Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer |
| title_full | Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer |
| title_fullStr | Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer |
| title_full_unstemmed | Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer |
| title_short | Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer |
| title_sort | current data and future perspectives on patients with atrial fibrillation and cancer |
| topic | atrial fibrillation cancer anticoagulation |
| url | https://www.mdpi.com/2072-6694/15/22/5357 |
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