Journal ArticleDOI
Epidemiology of first and recurrent venous thromboembolism in patients with active cancer. A population-based cohort study.
TLDR
An observational cohort study was undertaken to estimate the incidence of first and recurrent venous thromboembolism in patients with active cancer, finding rates were similar after initial pulmonary embolism and after initial deep-vein thrombosis.Abstract:
Population studies on the incidence of venous thromboembolism (VTE) in patients with active cancer are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The source population consisted of all patients in the UK Clinical Practice Research Datalink, with additional information on hospitalisation and cause of death, between 2001 and 2011. A cancer-related clinical diagnosis or therapy within the 90 days before or after a VTE constituted an active-cancer-associated VTE. Incidence rates of first VTE among patients with active cancer and incidence rates of recurrent VTE during the 10-year observational period after a first VTE event were estimated. Incidence rates of all-cause mortality and age- and gender-specific mortality were also calculated. There were 6,592 active-cancer-associated VTEs with a total of 112,738 cancer-associated person-years of observation. The incidence rate of first VTE in patients with active cancer was 5.8 (95 % confidence interval 5.7–6.0) per 100 person-years. A first VTE recurrence was observed in 591 patients. The overall incidence rate for recurrence was 9.6 (95 % confidence interval 8.8–10.4) per 100 person-years, with a peak at 22.1 in the first six months. Recurrence rates were similar after initial pulmonary embolism and after initial deep-vein thrombosis. The mortality risk after VTE was considerable, with 64.5 % mortality after one year and 88.1 % after 10 years. VTE in patients with active cancer is common and associated with high recurrence and mortality rates. Efforts are needed to prevent VTE and reduce recurrence, especially in the first year after VTE diagnosis.read more
Citations
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Journal ArticleDOI
Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis.
Stavros K. Kakkos,Manjit Gohel,Niels Bækgaard,Rupert Bauersachs,Sergi Bellmunt-Montoya,Stephen A. Black,Stephen A. Black,Arina J. ten Cate-Hoek,Ismail Elalamy,Florian K. Enzmann,George Geroulakos,Anders Gottsäter,Beverley J. Hunt,Armando Mansilha,Andrew N. Nicolaides,Andrew N. Nicolaides,Per Morten Sandset,Gerard Stansby,Gerard Stansby,Gert J. de Borst,Frederico Bastos Gonçalves,Nabil Chakfe,Robert J. Hinchliffe,Philippe Kolh,Igor Koncar,Jes S. Lindholt,Riikka Tulamo,Christopher P. Twine,Frank Vermassen,Anders Wanhainen,Marianne G. De Maeseneer,Anthony J. Comerota,Peter Gloviczki,Marieke J. H. A. Kruip,Manuel Monreal,Paolo Prandoni,Melina Vega de Ceniga +36 more
TL;DR: The European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis as discussed by the authors have been published for the management of venous thrombotic vessels.
Journal ArticleDOI
Venous thromboembolism in cancer patients: a population-based cohort study.
Frits I. Mulder,Frits I. Mulder,Erzsébet Horváth-Puhó,N. van Es,H.W.M. van Laarhoven,Lisbeth Nørum Pedersen,Florian Moik,Cihan Ay,Cihan Ay,H. R. Büller,Henrik Toft Sørensen +10 more
TL;DR: The risk of venous thromboembolism in cancer patients is increasing steadily and is 9-fold higher than in the general population.
Journal ArticleDOI
The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis.
Frits I. Mulder,Matteo Candeloro,Pieter W. Kamphuisen,Marcello Di Nisio,Patrick M.M. Bossuyt,Noori A.M. Guman,Kirsten F. Smit,Harry R. Büller,Nick van Es +8 more
TL;DR: The Khorana score can be used to select ambulatory cancer patients at high risk of venous thromboembolism for thromboprophylaxis; however, most events occur outside this high-risk group.
Journal ArticleDOI
Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy
Marcello Di Nisio,Ettore Porreca,Matteo Candeloro,Michele De Tursi,Ilaria Russi,Anne W S Rutjes +5 more
TL;DR: This update confirms that primary thromboprophylaxis with LMWH significantly reduced the incidence of symptomatic VTE in ambulatory cancer patients treated with chemotherapy and suggests that the quality of the evidence ranged from high to very low across the different outcomes and comparisons.
Journal ArticleDOI
Clinical Impact of Bleeding in Cancer-Associated Venous Thromboembolism: Results from the Hokusai VTE Cancer Study.
Noémie Kraaijpoel,Marcello Di Nisio,Frits I. Mulder,Nick van Es,Jan Beyer-Westendorf,Marc Carrier,David A. Garcia,Michael A. Grosso,Ajay K. Kakkar,Michele Mercuri,Saskia Middeldorp,Cristhiam Rojas Hernandez,Amparo Santamaría,Lee Schwocho,Annelise Segers,Peter Verhamme,Tzu-Fei Wang,Jeffrey I. Weitz,George Zhang,Jeffrey I. Zwicker,Harry R. Büller,Gary E. Raskob +21 more
TL;DR: It is suggested that while oral edoxaban is an appropriate alternative to subcutaneous dalteparin for treatment of cancer-associated VTE, the use of Edoxaban in patients with gastrointestinal cancer requires careful benefit-risk weighting.
References
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Journal ArticleDOI
Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Clive Kearon,Elie A. Akl,Anthony J. Comerota,Paolo Prandoni,Henri Bounameaux,Samuel Z. Goldhaber,Michael E. Nelson,Philip S. Wells,Michael K. Gould,Francesco Dentali,Mark Crowther,Susan R. Kahn +11 more
TL;DR: Strong recommendations apply to most patients, whereas weak recommendations are sensitive to differences among patients, including their preferences.
Journal ArticleDOI
Prevention of Venous Thromboembolism* American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th Edition)
William H. Geerts,David Bergqvist,Graham F. Pineo,John A. Heit,Charles M. Samama,Michael R. Lassen,Clifford W. Colwell +6 more
TL;DR: This article discusses the prevention of venous thromboembolism (VTE) and is part of the Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).
Journal ArticleDOI
Acute pulmonary embolism: clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER)
TL;DR: Data from ICOPER provide rates and highlight adverse prognostic categories that will help in planning of future trials of high-risk PE patients and highlight significant prognostic factors associated with death.
Journal ArticleDOI
Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study.
Marc D. Silverstein,Marc D. Silverstein,John A. Heit,David N. Mohr,Tanya M. Petterson,W. Michael O'Fallon,L. Joseph Melton +6 more
TL;DR: The incidence of pulmonary embolism has decreased over time, the incidence of deep vein thrombosis remains unchanged for men and is increasing for older women, and the need for more accurate identification of patients at risk for venous thromboembolism is emphasized.
Journal ArticleDOI
Low-Molecular-Weight Heparin versus a Coumarin for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer
Agnes Y.Y. Lee,Mark Levine,Ross I. Baker,Chris Bowden,Ajay K. Kakkar,Martin H. Prins,Frederick R. Rickles,Jim A. Julian,Susan Haley,Michael J. Kovacs,Michael Gent +10 more
TL;DR: In patients with cancer and acute venous thromboembolism, dalteparin was more effective than an oral anticoagulant in reducing the risk of recurrent thrombosis without increasing therisk of bleeding.