Anticoagulation in patients with atrial fibrillation, thrombocytopenia and hematological malignancy.
J Thromb Thrombolysis
; 52(2): 590-596, 2021 Aug.
Article
em En
| MEDLINE
| ID: mdl-33523384
ABSTRACT
Managing anticoagulation in hematological malignancy patients with atrial fibrillation and thrombocytopenia is a clinical challenge with limited data. We aimed to identify anticoagulation management strategies and evaluate bleeding and thrombosis rates associated with each approach. A retrospective cohort study in Israel and the Netherlands was conducted. Patients with hematological malignancy and atrial fibrillation were indexed when platelets were < 50 × 109/L and followed for 30 days. The cohort included 61 patients of whom 42 (69%) had anticoagulation held at index. On multivariate analysis, holding anticoagulation was associated with age < 65 years and atrial fibrillation diagnosed within 30 days prior index. Clinically relevant bleeding was diagnosed in 7 (16.7%) and 1 (5.3%) of patients who had anticoagulation held and continued respectively, while arterial thromboembolism occurred in 1 patient in each group (2.4% and 5.3%, respectively). All-cause mortality rate was high at 45%. Accordingly, the 30-day bleeding risk may outweigh the risk of arterial thromboembolism in hematological malignancy, platelets < 50 × 109/L and atrial fibrillation.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Tipos_de_cancer
/
Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Trombocitopenia
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Tromboembolia
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Neoplasias Hematológicas
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Anemia
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Aged
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Humans
Idioma:
En
Revista:
J Thromb Thrombolysis
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Israel