Anticoagulation Strategies in Patients With Cancer JACC Review Topic of the Week

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:73

Review

Mosarla, Ramya C.¹  Vaduganathan, Muthiah²  Qamar, Arman³  Moslehi, Javid⁴  Piazza, Gregory²  Giugliano, Robert P.³ 

[1] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA

[2] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA

[3] Harvard Med Sch, Brigham & Womens Hosp, Div Cardiovasc Med, TIMI Study Grp, Boston, MA 02115 USA

[4] Vanderbilt Univ, Med Ctr, Dept Med, Cardiooncol Program, Nashville, TN USA

关键词: anticoagulation;    atrial fibrillation;    bleeding;    cancer;    cardiooncology;    venous thromboembolism;   

DOI  :  10.1016/j.jacc.2019.01.017

来源: Elsevier

【 摘 要 】

Patients with active cancer are at an increased risk of arterial and venous thromboembolism (VTE) and bleeding events. Historically, in patients with cancer, low molecular weight heparins have been preferred for treatment of VTE, whereas warfarin has been the standard anticoagulant for stroke prevention in patients with atrial fibrillation (AF). More recently, direct oral anticoagulants (DOACs) have been demonstrated to reduce the risk of venous and arterial thromboembolism in large randomized clinical trials of patients with VTE and AF, respectively, thus providing an attractive oral dosing option that does not require routine laboratory monitoring. In this review, we summarize available clinical trial data and guideline recommendations, and outline a practical approach to anticoagulation management of VTE and AF in cancer. (c) 2019 by the American College of Cardiology Foundation.

【 授权许可】

Free