ArticleAnatolian journal of cardiology2026
Comparison of Direct Oral Anticoagulants and Low-Molecular-Weight Heparins in Cancer Patients with Nonvalvular Atrial Fibrillation: Insights from a Single-Center Experience.
Article in Anatolian journal of cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAtrial fibrillation (AF) is frequently encountered in patients with cancer and poses challenges for anticoagulant management. The present study was conducted to compare clinical outcomes associated with direct oral anticoagulants (DOACs) and low-molecular-weight heparin (LMWH) in individuals with active malignancy and nonvalvular AF (NVAF).
methodsData from patients with active cancer who received LMWH or DOACs for NVAF were retrospectively screened. Efficacy, safety, and survival outcomes were analyzed.
resultsThe study enrolled 222 patients, of whom 25.7% received LMWH and 74.3% received DOACs. Cancer stage, type, and treatment were comparable between groups. The DOAC group had higher CHA2DS2-VA (3.13 ± 1.21 vs. 2.42 ± 1.33; P < .001) and HAS-BLED scores (2.13 ± 0.83 vs. 1.84 ± 0.79; P = .022). The primary composite endpoint occurred more frequently in the LMWH group (17.5% vs. 12.1%; log-rank P = .036). Myocardial infarction was significantly higher in the LMWH group (8.8% vs. 1.8%; log-rank P = .003), while rates of ischemic stroke (3.5% vs. 6.7%; log-rank P = .927) and venous thromboembolism (5.3% vs. 4.8%; P = .537) were similar. Any bleeding (17.5% vs. 13.3%; log-rank P = .039) and major bleeding (7.0% vs. 1.8%; log-rank P = .010) were more frequent with LMWH, whereas clinically relevant non-major bleeding was comparable (10.5% vs. 11.5%; log-rank P = .359). All-cause mortality was significantly higher in the LMWH group (75.4% vs. 49.1%; log-rank P < .001), and LMWH use independently predicted mortality (hazard ratio = 2.14, P < .001, 95%CI: 1.45-3.17).
conclusionAlthough unmeasured confounders such as drug adherence and selection bias cannot be excluded due to the retrospective design, DOACs appear to be more effective and safer than LMWH in cancer patients with AF.
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