Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. Jun 16, 2026; 14(17): 118087
Published online Jun 16, 2026. doi: 10.12998/wjcc.v14.i17.118087
Published online Jun 16, 2026. doi: 10.12998/wjcc.v14.i17.118087
Direct oral anticoagulants vs low-molecular-weight heparins for cancer-associated thromboembolism
Faseeh Haider, Department of Internal Medicine, Allama Iqbal Medical College, Lahore 54550, Punjab, Pakistan
Faizan Ahmed, Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ 07753, United States
Yusra Junaid, Department of Internal Medicine, Dow Medical College, Karachi 74200, Sindh, Pakistan
Maliha Khalid, Department of Medicine, Jinnah Sindh Medical University, Karachi 75510, Sindh, Pakistan
Areej Dar, Department of Medicine, Shaikh khalifa bin Zayed Al Nahyan Medical College, Lahore 54600, Punjab, Pakistan
Muhammad Arham, Department of Medicine, Sheikh Zayed Medical College, Rahimyar Khan 64200, Punjab, Pakistan
Aman Ullah, Department of Internal Medicine, University of Missouri-Columbia, Columbia, MO 65211, United States
Saba Aliha, Department of Medicine, Multan Medical and Dental College, Multan 06006, Punjab, Pakistan
Muhammad Usman Arshad, Department of Medicine, Shalamar Medical and Dental College, Lahore 54840, Punjab, Pakistan
Khadija Naeem, Department of Medicine, Montefiore St.Luke’s Cornwall, New York, NY 12518, United States
Muhammad Moseeb Ali Hashim, Department of Pathology, University of Missouri-Columbia, Columbia, MO 65211, United States
Najam Gohar, Department of Internal Medicine, Ameer-ud-Din Medical College, Postgraduate Medical Institute, Lahore 54000, Punjab, Pakistan
Asha Ricciuti, Department of Medicine, SSM Health St Louis University Hospital, St. Louis, MO 63104, United States
Vipul Bhanderi, Department of Medicine, University of Missouri-Columbia, Columbia, MO 65211, United States
Fawaz Alenezi, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, United States
Brijesh Patel, Department of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46202, United States
Author contributions: Haider F designed the research study; Haider F and Junaid Y led the project; Khalid M, Dar A, Aliha S, Naeem K, Ali M, Arham M and Arshad U screened the articles and extracted the data; Khalid M, Dar A, Aliha S and Naeem K wrote the manuscript; Hashim MMA, Arham M, Ullah A, Gohar N analyzed the data; Ahmed F, Ricciuti A, Bhanderi V, Alenezi F, Patel B reviewed the manuscript. All authors have read and approved the final manuscript.
AI contribution statement: We did use AI tools solely for paraphrasing certain sentences to improve clarity and readability. All content, data analysis, study design, results, and interpretations are original, based on our own research and writing. No AI was involved in generating ideas, methods, or conclusions. We are happy to provide further details or revised sections if needed.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Faseeh Haider, Researcher, Department of Internal Medicine, Allama Iqbal Medical College, Allama Shabbir Ahmed Usmani Road, Lahore 54550, Punjab, Pakistan. faseehhaidermd@gmail.com
Received: December 23, 2025
Revised: March 11, 2026
Accepted: May 12, 2026
Published online: June 16, 2026
Processing time: 162 Days and 13.1 Hours
Revised: March 11, 2026
Accepted: May 12, 2026
Published online: June 16, 2026
Processing time: 162 Days and 13.1 Hours
Core Tip
Core Tip: Cancer-associated thrombosis continues to be a major cause of morbidity and mortality in oncology patients, necessitating the selection of anticoagulation medication. This study examined the efficacy and safety of direct oral anticoagulants vs low-molecular-weight heparins. Direct oral anticoagulants showed comparable protection against venous thromboembolism and severe bleeding, with apixaban demonstrating a significant reduction in venous thromboembolism recurrence. Metastasis and platelet count were found as major moderators of bleeding and mortality outcomes in study, indicating the need for personalized anticoagulation methods in cancer treatment.