RESUMEN
(1) Introduction: Cancer and atrial fibrillation (AF) are increasingly coexisting medical challenges. These two conditions share an increased thrombotic and bleeding risk. Although optimal regimens of the most suitable anti-thrombotic therapy are now affirmed in the general population, cancer patients are still particularly understudied on the matter; (2) Aims And Methodology: This metanalysis (11 studies (incl. 266,865 patients)) aims at evaluating the ischemic-hemorrhagic risk profile of oncologic patients with AF treated with oral anticoagulants (vitamin K antagonists vs. direct oral anticoagulants); (3) Results: In the oncological population, DOACs confer a benefit in terms of the reduction in ischemic, hemorrhagic and venous thromboembolic events. However, ischemic prevention has a non-insignificant bleeding risk, lower than Warfarin but significant and higher than the non-oncological patients; (4) Conclusions: Anticoagulation with DOACs provides a higher safety profile with respect to VKAs in terms of stroke reduction and a relative bleeding reduction risk. Further studies are needed to better assess the optimal anticoagulation strategy in cancer patients with AF.
RESUMEN
We propose an innovative statistical-numerical method to model spatio-temporal data, observed over a generic two-dimensional Riemanian manifold. The proposed approach consists of a regression model completed with a regularizing term based on the heat equation. The model is discretized through a finite element scheme set on the manifold, and solved by resorting to a fixed point-based iterative algorithm. This choice leads to a procedure which is highly efficient when compared with a monolithic approach, and which allows us to deal with massive datasets. After a preliminary assessment on simulation study cases, we investigate the performance of the new estimation tool in practical contexts, by dealing with neuroimaging and hemodynamic data.