Fig. 3.

Algorithm for antithrombotic therapy in patients with cancer-related atrial fibrillation. Indication algorithm for anticoagulation in patients with cancer-related atrial fibrillation. Figure modified from [4]. 5-FU 5-fluorouracil, CHA2DS2-VASc congestive heart failure, hypertension, age > 75 years (dual), diabetes mellitus, stroke (dual), vascular disease, age 65–74 years, and sex (female), CrCl creatinine clearance, CYP cytochrome P450, DOACs direct oral anticoagulants, EPO erythropoietin, HAS-BLED hypertension, abnormal renal and liver function, stroke, history of or predisposition to bleeding, labile international normalized ratio, age > 65 years, and concomitant use of drugs or alcohol, LMWH low-molecular-weight heparin, P-gp P-glycoprotein. ^aFor patients with very high bleeding risk and indication for anticoagulation the decision should be individualized. Considered in a multidisciplinary discussion if left atrial appendage occlusion. ^bAnticoagulant selection depends on clinical status, comorbidities, and possible interactions with the patient’s anticancer therapy. ^cCurrently, there is limited scientific evidence on its use in patients under active anticancer therapy and atrial fibrillation