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心房颤动与癌症之间的联系:一个治疗难题。

Crosslink between atrial fibrillation and cancer: a therapeutic conundrum.

作者信息

Nardi Ermanno, Santoro Ciro, Prastaro Maria, Canonico Mario Enrico, Paolillo Stefania, Gargiulo Giuseppe, Gargiulo Paola, Parlati Antonio L M, Basile Christian, Bardi Luca, Giuliano Mario, Esposito Giovanni

机构信息

Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

Department of Clinical Medicine and Surgery, University Federico II Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy.

出版信息

Cardiooncology. 2024 Aug 7;10(1):48. doi: 10.1186/s40959-024-00243-z.

Abstract

Atrial fibrillation (AF) is more common in patients with malignancies than in general population. The pathophysiological processes include the pro-inflammatory condition and the exaggerated inflammatory reaction to chemotherapy, radiotherapy, and surgery interventions. Thus, it is pivotal to decrease morbidity and mortality in this group by providing appropriate care and prevention. In this subset, the risk of thromboembolic and bleeding events is high and the common risk score such as CHA2DS2-VASc and HAS-BLED employed in non-oncologic patients have limited evidence in cancer patients. A paucity of evidence in the setting in individuals having both malignancies and atrial fibrillation entangle the clinician when it comes to therapeutic management. Tailored management is recommended of anticoagulation treatment could be difficult, and there is. In this review, we try to explain the mechanism of AF in cancer patients as well as its management in this setting.

摘要

心房颤动(AF)在恶性肿瘤患者中比在普通人群中更为常见。其病理生理过程包括促炎状态以及对化疗、放疗和手术干预的过度炎症反应。因此,通过提供适当的护理和预防措施来降低该群体的发病率和死亡率至关重要。在这一亚组中,血栓栓塞和出血事件的风险很高,而在非肿瘤患者中使用的常见风险评分(如CHA2DS2-VASc和HAS-BLED)在癌症患者中的证据有限。在患有恶性肿瘤和心房颤动的个体中,证据的匮乏使得临床医生在进行治疗管理时陷入困境。推荐进行个体化管理,因为抗凝治疗可能很困难,确实如此。在本综述中,我们试图解释癌症患者心房颤动的机制及其在这种情况下的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09e1/11304574/e8bcefbc9ba1/40959_2024_243_Fig1_HTML.jpg

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