Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
July 30, 2026Heart & Lung

Anticoagulation strategies and pulmonary safety in patients with active lung cancer and atrial fibrillation: A large-scale, competing risk analysis of 2000 patients

View Full Paper
Ask AI
Bookmark
Share

Key result

DOACs linked to ~58% fewer ischemic strokes and less hemoptysis vs VKAs in AF and lung cancer.

  • sHR 0.42
  • 95% CI 0.24-0.72
  • P=0.002
  • n=2,000

Why the study?

Anticoagulation in active lung cancer is complicated by high bleeding and thrombotic risks, and data on lung-cancer-specific safety, especially massive hemoptysis, remain limited.

Do DOACs reduce ischemic stroke and massive hemoptysis compared to VKAs in patients with active lung cancer and atrial fibrillation?

Population

2000 patients with active lung cancer and AF

Comparison

DOACs vs VKAs vs LMWH vs untreated cohort

Design

Retrospective observational study

Follow-up

12 months

Authors

EKErsin KayaTŞTarık ŞimşekİMİnan Mutlu

Discussion

Loading...

Member takes

Overview

May support DOAC preference over VKAs in lung cancer with AF; leaves open need for randomized confirmation.

Key Points

  • This study aims to evaluate the efficacy and safety of various anticoagulation strategies in patients with active lung cancer and atrial fibrillation.
  • Retrospective observational study of 2000 patients from 2018 to 2025
  • Evaluated Direct Oral Anticoagulants, Vitamin K Antagonists, Low-Molecular-Weight Heparin, and untreated cohort
  • Used Inverse Probability of Treatment Weighting and Fine-Gray models to analyze competing risks.
  • Untreated cohort had a 13.3% annual ischemic stroke rate.
  • DOACs significantly reduced ischemic stroke risk compared to VKAs (sHR: 0.42; 95% CI: 0.24-0.72; P = 0.002).
  • DOACs had a lower incidence of massive hemoptysis (1.5%) compared to VKAs (5.0%; P = 0.001).

Study Design

Type

Observational (n=2,000)

Structured PICO

Do DOACs reduce ischemic stroke and massive hemoptysis compared to VKAs in patients with active lung cancer and atrial fibrillation?

P
Population
2000 patients with active lung cancer and atrial fibrillation, evaluated retrospectively for 12-month outcomes of various anticoagulation strategies.
E
Exposure
Direct Oral Anticoagulants (DOACs)
C
Comparator
Vitamin K Antagonists (VKAs), Low-Molecular-Weight Heparin (LMWH), and an untreated cohort
O
Outcome
12-month cumulative incidence of ischemic stroke and massive hemoptysishard clinical

Main Result

Hazard Ratio: 0.42 (95% CI 0.24–0.72)

p-value: p=0.002

DOACs provide superior stroke prevention and lower pulmonary bleeding risk compared to VKAs in patients with active lung cancer and atrial fibrillation.

Cite This Study

Kaya et al. (2026) conducted an observational in active lung cancer and atrial fibrillation (n=2,000). Direct Oral Anticoagulants (DOACs) vs. Vitamin K Antagonists (VKAs) was evaluated on 12-month cumulative incidence of ischemic stroke (sHR 0.42, 95% CI 0.24-0.72, p=0.002). DOACs significantly reduced ischemic stroke risk compared to VKAs (sHR 0.42; 95% CI 0.24-0.72; P=0.002) and resulted in less massive hemoptysis (1.5% vs 5.0%) in active lung cancer and AF.

synapsesocial.com/papers/6a6b034960e2b924d3ea2581https://doi.org/10.1016/j.hrtlng.2026.102898
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Direct oral anticoagulants and warfarin in atrial fibrillation patients with cancer by anticoagulation quality2026
  2. 2Anticoagulation for atrial fibrillation in active cancer: what the cardiologists think2020 · 25 citations
  3. 3Relationships, Current Issues, Safety and Efficacy of Oral Anticoagulation in Cancer Patients with Atrial Fibrillation2023
  4. 4Evaluating efficacy and safety of oral anticoagulation in adult patients with atrial fibrillation and cancer: A systemic review and meta-analysis2023 · 4 citations
  5. 5Systematic Review and Meta-Analysis of Oral Anticoagulant Therapy in Atrial Fibrillation Cancer Patients2023 · 9 citations