What is the benefit of anticoagulants for secondary stroke prevention in patients with a stroke attributable to hypercoagulability from cancer?
The benefit of anticoagulants for secondary stroke prevention in patients with a stroke attributable to hypercoagulability from cancer is not well established. Subgroup analysis in the ROCKET AF trial comparing rivaroxaban and warfarin in patients with AF and history of cancer showed similar rates of stroke and systemic embolism (0.52, 95% CI, 0.22 1.21) and nonmajor bleeding (0.45, 95% CI, 0.17 0.79). A literature search of 31 660 patients in 5 trials in patients with AF and cancer DOACs showed a trend for more efficacy and better safety compared with warfarin. Further research is needed to understand the particular need of anticoagulation to prevent stroke in different types of cancers and to determine the best treatment regimen for these patients.