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Hamostaseologie
DOI: 10.1055/a-2337-4025
Review Article

Antithrombotic Therapy in Cancer Patients with Cardiovascular Diseases: Daily Practice Recommendations by the Hemostasis Working Party of the German Society of Hematology and Medical Oncology (DGHO) and the Society for Thrombosis and Hemostasis Research (GTH e.V.)

Stefani Parmentier
1   Tumorzentrum, St. Claraspital Tumorzentrum, St. Claraspital, Basel, Basel-Stadt, Switzerland
,
Steffen Koschmieder
2   Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
,
Larissa Henze
3   Department of Medicine, Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
4   Department of Internal Medicine II, Hematology, Oncology and Palliative Medicine, Asklepios Hospital Harz, Goslar, Germany
,
Martin Griesshammer
5   University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, Johannes Wesling Medical Center Minden, University of Bochum, Minden, Germany
,
Axel Matzdorff
6   Department of Internal Medicine II, Asklepios Clinic Uckermark, Schwedt, Germany
,
Tamam Bakchoul
7   Department of Transfusion Medicine, Medical Faculty of Tübingen, University of Tübingen, Tübingen, Germany
,
Florian Langer
8   Center for Oncology, University Cancer Center Hamburg (UCCH), II Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany
,
Rosa Sonja Alesci
9   IMD Blood Coagulation Center, Hochtaunus/Frankfurt, Bad Homburg, Germany
,
Daniel Duerschmied
10   Department of Cardiology, Hemostaseology, Angiology and Medical Intensive Care, Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
,
Goetz Thomalla
11   Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Hanno Riess
12   Division of Hematology, Oncology and Tumorimmunology, Department of Medical, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
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Abstract

Active cancer by itself but also chemotherapy is associated with an increased risk of cardiovascular disease (CVD) and especially coronary artery disease (CAD) and atrial fibrillation (AF). The frequency of CVD, CAD, and AF varies depending on comorbidities (particularly in older patients), cancer type, and stage, as well as the anticancer therapeutic being taken. Many reports exist for anticancer drugs being associated with CVD, CAD, and AF, but robust data are often lacking. Because of this, each patient needs an individual structured approach concerning thromboembolic and bleeding risk, drug–drug interactions, as well as patient preferences to evaluate the need for anticoagulation therapy and targeting optimal symptom control. Interruption of specific cancer therapy should be avoided to reduce the potential risk of cancer progression. Nevertheless, additional factors like thrombocytopenia and anticoagulation in the elderly and frail patient with cancer cause additional challenges which need to be addressed in daily clinical management. Therefore, the aim of these recommendations is to summarize the available scientific data on antithrombotic therapy (both antiplatelet and anticoagulant therapy) in cancer patients with CVD and in cases of missing data providing guidance for optimal careful decision-making in daily routine.

Keywords

cancer - atrial fibrillation - antithrombotic therapy - coronary artery disease - platelet disorders

Authors' Contributions

S.P., H.R.: conceived and planned the project, wrote parts of the manuscript, completed and revised the whole manuscript; S.K., L.H., M.G., A.M., T.B., F.L., R.S.A.: wrote paragraphs of the manuscript and revised the manuscript; D.D., G.T.: revised the manuscript and added relevant aspects to the manuscript. All authors have read and agreed to the published version of the manuscript.




Publication History

Received: 01 April 2024

Accepted: 30 May 2024

Article published online:
15 July 2024

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