Stroke risk assessment and atrial fibrillation (AF) in cancer patients

The development of atrial fibrillation (AF) might be associated with cancer or with cancer therapies, and its treatment poses a major challenge. It remains uncertain whether one is the cause or consequence of the other, or whether they simply coexist. There are approximately 33 million people worldwide with atrial fibrillation (AF). Moreover, there is a lack of clinical data about the use of anticoagulation for patients with cancer and atrial fibrillation (AF), which is common in patients with both conditions. Patients with cancer and AF have a similar risk of stroke to those in the general population, but they have a substantially higher risk of bleeding regardless of which anticoagulant agent is used; this makes anticoagulation-related decisions complex and general population evidence is unlikely to be useful. Discontinuing anticoagulation in patients who are at high risk of bleeding and who have a moderate bleeding risk without high thromboembolic risk, and continuing anticoagulation for patients who are at low risk of bleeding are recommended. Risk assessments play a crucial role in clinical practice. As a result, understanding the evidence supporting the individual risk factors is crucial to help guide the management of patients with complex conditions such as atrial fibrillation (AF).