Arterial Thromboembolism in Patients With AF and CHA2DS2-VASc Score 0-2 With and Without Cancer

Cardio-Oncology: A New Discipline in Medicine and Its Relevance to Hematology

“…This recommendation has been validated by a recent analysis showing a 2.13% 12-month cumulative incidence of ATE in cancer patients with AF, with the highest risk in male patients with a score of 1 and female patients with a score of 2. 126 In cancer patients with AF and high bleeding risk, a recent study has shown the feasibility of left atrial appendage occlusion. 127 The efficacy of anticoagulation in preventing ATE in cancer patients without AF is poorly understood.…”

Arterial Thromboembolism in Japanese Patients With Cancer

“… 2 , 3 , 4 Approximately 15% of patients with cancer experience VTE during the course of their illness. 5 Regarding arterial thrombosis, previous studies have indicated an increased risk for arterial thromboembolism (ATE) in patients with cancer, 6 , 7 , 8 , 9 , 10 , 11 , 12 with a cumulative incidence rate ranging from 1.1% to 6.5% in the first year after cancer diagnosis. 9 , 10 , 11 , 12 Notably, the risk is particularly high immediately after cancer diagnosis.…”

“… 5 Regarding arterial thrombosis, previous studies have indicated an increased risk for arterial thromboembolism (ATE) in patients with cancer, 6 , 7 , 8 , 9 , 10 , 11 , 12 with a cumulative incidence rate ranging from 1.1% to 6.5% in the first year after cancer diagnosis. 9 , 10 , 11 , 12 Notably, the risk is particularly high immediately after cancer diagnosis. 9 , 10 , 11 Additionally, advanced stages of cancer and atrial fibrillation contribute to an increased risk for ATE in patients with cancer.…”

CHA2DS2-VASc Score in Cardio-Oncology

“…In this issue of JACC: CardioOncology , Leader et al 16 report the results of a population-based retrospective cohort of patients with a CHA 2 DS 2 -VASc score of 0 to 2 and not receiving anticoagulation at the time of the cancer diagnosis. Patients were categorized into 4 subgroups: AF and cancer (n = 1,411), AF and no cancer (n = 4,233), no AF and cancer (n = 4,233), and no AF and no cancer (n = 19,421).…”

“…In summary, patients with cancer and a low CHA 2 DS 2 VASc score are left with a higher residual stroke rate, which is partially explained by our nonspecific characterization of AF. The paper by Leader et al 16 sharpens the profile of patients with a CHA 2 DS 2 -VASc score of 0 to 2 who will benefit from the use of anticoagulation. This study supports the use of anticoagulant therapy in men with a CHA 2 DS 2 -VASc score =1 and women with a CHA 2 DS 2 -VASc score = 2 presenting with cancer and AF in the absence of a prohibitive bleeding risk.…”