Atrial Fibrillation in Active Cancer Patients: Expert Position Paper and Recommendations
Rev Esp Cardiol (Engl Ed). 2019 Sep;72(9):749-759.
doi: 10.1016/j.rec.2019.03.019.
Epub 2019 Aug 9.
[Article in
English,
Spanish]
Authors
Teresa López-Fernández
1
, Ana Martín-García
2
, Inmaculada Roldán Rabadán
3
, Cristina Mitroi
4
, Pilar Mazón Ramos
5
, Pablo Díez-Villanueva
6
, Carlos Escobar Cervantes
3
, Concepción Alonso Martín
7
, Gonzalo Luis Alonso Salinas
8
, Meritxell Arenas
9
, Vicente Ignacio Arrarte Esteban
10
, Francisco Ayala de La Peña
11
, Antonio Castro Fernández
12
, Héctor García Pardo
13
, Ramón García-Sanz
14
, José Ramón González Porras
14
, Esteban López de Sá
3
, Teresa Lozano
10
, Pascual Marco Vera
15
, Virginia Martínez Marín
16
, Dolores Mesa Rubio
17
, Ángel Montero
18
, Gerard Oristrell
19
, Armando Pérez de Prado
20
, Sonia Velasco Del Castillo
21
, Juan Antonio Virizuela Echaburu
2
, Eduardo Zatarain-Nicolás
22
, Manuel Anguita Sánchez
17
, Juan Tamargo Menéndez
23
; Expert reviewers
Affiliations
- 1 Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, CIBERCV, Madrid, Spain. Electronic address: tlfernandez8@gmail.com.
- 2 Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, CIBERCV, Salamanca, Spain.
- 3 Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, CIBERCV, Madrid, Spain.
- 4 Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
- 5 Servicio de Cardiología, Hospital Clínico Santiago de Compostela, CIBERCV, Santiago de Compostela, A Coruña, Spain.
- 6 Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain.
- 7 Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- 8 Servicio de Cardiología, Hospital Ramón y Cajal, CIBERCV, Madrid, Spain.
- 9 Servicio de Oncología Radioterápica, Hospital Universitario San Juan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain.
- 10 Servicio de Cardiología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain.
- 11 Servicio de Hematología y Oncología Médica, Hospital Morales Meseguer, Murcia, Spain.
- 12 Servicio de Cardiología, Hospital Virgen Macarena, Sevilla, Spain.
- 13 Servicio de Cardiología, Hospital Santos Reyes, Aranda de Duero, Burgos, Spain.
- 14 Departamento de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain.
- 15 Servicio de Hematología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain.
- 16 Servicio de Oncología Médica, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
- 17 Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
- 18 Servicio de Oncología Radioterápica, Centro Integral Oncológico Clara Campal (CIOCC), Hospital Universitario HM Sanchinarro, Madrid, Spain.
- 19 Servicio de Cardiología, Hospital Universitario Vall d'Hebron, CIBERCV, Barcelona, Spain.
- 20 Servicio de Cardiología, Hospital Universitario de León, León, Spain.
- 21 Servicio de Cardiología, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain.
- 22 Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain.
- 23 Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, CIBERCV, Madrid, Spain.
- 24 Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Murcia, Spain.
Abstract
Improvements in survival among cancer patients have revealed the clinical impact of cardiotoxicity on both cardiovascular and hematological and oncological outcomes, especially when it leads to the interruption of highly effective antitumor therapies. Atrial fibrillation is a common complication in patients with active cancer and its treatment poses a major challenge. These patients have an increased thromboembolic and hemorrhagic risk but standard stroke prediction scores have not been validated in this population. The aim of this expert consensus-based document is to provide a multidisciplinary and practical approach to the prevention and treatment of atrial fibrillation in patients with active cancer. This is a position paper of the Spanish Cardio-Oncology working group and the Spanish Thrombosis working group, drafted in collaboration with experts from the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology, and the Spanish Society of Hematology.
Keywords:
Anticoagulantes; Anticoagulants; Atrial fibrillation; Cardio-Oncology; Cardio-Oncología; Fibrilación auricular.
Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Anticoagulants / therapeutic use
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Atrial Fibrillation / complications*
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Cardiology*
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Consensus*
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Humans
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Medical Oncology*
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Neoplasms / complications*
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Risk Factors
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Societies, Medical*
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Spain
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Thromboembolism / etiology
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Thromboembolism / prevention & control*