Anticoagulation in patients with atrial fibrillation, thrombocytopenia and hematological malignancy

N. Livneh, D. Braeken, G. Drozdinsky, A. Gafter-Gvili, J. Seelig, U. Rozovski, T. Berger, P. Raanani, A. Falanga, H. ten Cate, G. Spectre, A. Leader*

*Corresponding author for this work

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1 Citation (Web of Science)

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 x 10(9)/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 x 10(9)/L and atrial fibrillation.
Original languageEnglish
Pages (from-to)590-596
Number of pages7
JournalJournal of Thrombosis and Thrombolysis
Volume52
Issue number2
Early online date1 Feb 2021
DOIs
Publication statusPublished - Aug 2021

Keywords

  • Anticoagulation
  • Atrial fibrillation
  • Bleeding
  • Ischemic stroke
  • Thrombocytopenia
  • anticoagulation
  • atrial fibrillation
  • bleeding
  • ischemic stroke
  • thrombocytopenia
  • DEFINITION
  • RISK
  • CANCER
  • STROKE
  • THROMBOEMBOLISM

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