Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation and Cancer

Shabtaie, Samuel A.; Tan, Nicholas; Ward, Robert C.; Lewis, Bradley R.; Yang, Eric H.; Holmes, David R.; Herrmann, Joerg

doi:10.1016/j.jaccao.2022.10.016

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…Based on the findings of this retrospective study by Shabtaie et al, 7 Watchman LAAO appears safe in cancer patients without increased ischemic stroke, procedural complications, or cardiovascular mortality compared with noncancer patients. Although LAAO vs anticoagulation was not directly evaluated in this study, LAAO appears to be a reasonable alternative for stroke prevention in cancer patients in whom the bleeding risk with anticoagulation may be potentially prohibitive.…”

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confidence: 88%

“…Increasing evidence from ASAP, EWOLUTION, and other studies suggest that a short duration of dual antiplatelet therapy post-LAAO without anticoagulation is safe 11 , 12 , 13 and may be more likely used in cancer patients with high bleeding risk. Additionally, the cancer patients studied by Shabtaie et al 7 were neither profoundly anemic nor thrombocytopenic (median platelet count = 186,000). Whether overall outcomes are similar in patients who are more thrombocytopenic or receiving cancer therapies that cause bone marrow suppression was not answered by this study even though bleeding rates would most certainly be lower with LAAO than lifelong anticoagulation.…”

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confidence: 93%

“…To explore the role of LAAO in this population, Shabtaie et al 7 studied LAAO in 55 cancer patients at 2 experienced centers as published in this issue of JACC: CardioOncology . The authors interrogated an institutional cancer registry and abstracted the CHA 2 Ds 2 -VASc score, cardiovascular comorbidities, and bleeding risk factors from the National Cardiovascular Data Registry (NCDR).…”

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confidence: 99%

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LAAO in Cardio-Oncology

Tung¹,

Chen²

2023

JACC: CardioOncology

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confidence: 88%

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confidence: 93%

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confidence: 99%

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LAAO in Cardio-Oncology

Tung¹,

Chen²

2023

JACC: CardioOncology

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“…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. A recent meta-analysis with over 10,000 patients found no reduction of ATE events in patients taking LMWH, DOACs, or warfarin.…”

Section: Risk Of Ate In Cancer Patientsmentioning

confidence: 99%

“…126 In cancer patients with AF and high bleeding risk, a recent study has shown the feasibility of left atrial appendage occlusion. 127…”

Section: Risk Of Ate In Cancer Patientsmentioning

confidence: 99%

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

Spannbauer,

Bergler-Klein

2024

Hamostaseologie

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Cardio-oncology, a burgeoning subspecialty, addresses the complex interplay between cardiology and oncology, particularly in light of increased cardiovascular (CV) disease mortality in cancer patients. This review provides a comprehensive overview of cardio-oncology with a focus on the therapies used in hematological malignancies. We explore the bidirectional relationship between heart failure and cancer, emphasizing the need for collaborative care. The review discusses risk stratification, highlighting the importance of baseline CV risk assessment and personalized surveillance regimens. Primary and secondary prevention strategies, including pharmacological interventions, are outlined. The review also delves into the cardiotoxicity associated with hematological cancer therapies, focusing on anthracyclines, Bruton kinase inhibitors, BCR-ABL tyrosine kinase inhibitors, CAR-T cell therapy, immune checkpoint inhibitors, multiple myeloma treatments, and hematopoietic stem cell transplantation. We then highlight the high risk of venous and arterial thromboembolisms in cancer patients and the challenges of anticoagulation management in cardio-oncology. Finally, the review touches on the importance of long-term follow-up and appropriate screening in cancer survivors at high risk of CV morbidity and mortality, based on their CV risk profile and the type and dose of cardiotoxic therapies they received such as anthracyclines or high radiation doses.

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