Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer

Leonardo De Luca
* ORCID logo ,
Irma Bisceglia
,
Massimiliano Camilli
,
Maria Laura Canali
,
Raffaella Mistrulli
,
Federico Andreoli
,
Guido Giacalone
,
Domenico Gabrielli
Version 1 : Received: 6 June 2023 / Approved: 7 June 2023 / Online: 7 June 2023 (08:36:40 CEST)

How to cite: De Luca, L.; Bisceglia, I.; Camilli, M.; Canali, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Gabrielli, D. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Preprints 2023, 2023060517. https://doi.org/10.20944/preprints202306.0517.v1 De Luca, L.; Bisceglia, I.; Camilli, M.; Canali, M.L.; Mistrulli, R.; Andreoli, F.; Giacalone, G.; Gabrielli, D. Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer. Preprints 2023, 2023060517. https://doi.org/10.20944/preprints202306.0517.v1

Abstract

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 as 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 mechanisms linking AF to cancer patients with a particular focus on therapeutic challenges in this population.

Keywords

atrial fibrillation; cancer; direct oral anticoagulants

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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