Predicting recurrences or major bleeding in cancer patients with venous thromboembolism

Javier Trujillo-Santos; José Antonio Nieto; Gregorio Tiberio; Andrea Piccioli; Pierpaolo Di Micco; Paolo Prandoni; Manuel Monreal

doi:10.1160/TH08-02-0125

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(03): 435-439
DOI: 10.1160/TH08-02-0125

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Predicting recurrences or major bleeding in cancer patients with venous thromboembolism

Findings from the RIETE Registry

Javier Trujillo-Santos

¹Departament of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia, Spain

,

José Antonio Nieto

²Department of Internal Medicine, Hospital Virgen de la Luz, Cuenca, Spain

,

Gregorio Tiberio

³Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Spain

,

Andrea Piccioli

⁴Medical and Surgical Science, Clinica Medica II, University of Padova, Padova, Italy

,

Pierpaolo Di Micco

⁵Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy

,

Paolo Prandoni

⁴Medical and Surgical Science, Clinica Medica II, University of Padova, Padova, Italy

,

Manuel Monreal

⁶Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; for the RIETE Investigators

› Author Affiliations

Abstract

Summary

Cancer patients with acute venous thromboembolism (VTE) have an increased incidence of recurrences and bleeding complications while on anticoagulant therapy. Methods RIETE is an ongoing registry of consecutive patients with acute VTE. We tried to identify which cancer patients are at a higher risk for recurrent pulmonary embolism (PE), deep vein thrombosis (DVT) or major bleeding. Up to May 2007, 3, 805 cancer patients had been enrolled in RIETE. During the first three months of follow-up after the acute, index VTE event, 90 (2.4%) patients developed recurrent PE, 100 (2.6%) recurrent DVT, 156 (4.1%) had major bleeding. Forty patients (44%) died of the recurrent PE,46 (29%) of bleeding. On multivariate analysis, patients aged <65 years (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.9–4.9), with PE at entry (OR: 1.9; 95% CI: 1.2–3.1), or with <3 months from cancer diagnosis to VTE (OR: 2.0; 95% CI: 1.2–3.2) had an increased incidence of recurrent PE. Those aged <65 years (OR: 1.6; 95% CI: 1.0–2.4) or with <3 months from cancer diagnosis (OR: 2.4; 95% CI: 1.5–3.6) had an increased incidence of recurrent DVT. Finally, patients with immobility (OR: 1.8; 95% CI: 1.2–2.7), metastases (OR: 1.6; 95% CI: 1.1–2.3), recent bleeding (OR: 2.4; 95% CI: 1.1–5.1), or with creatinine clearance <30 ml/ min (OR: 2.2; 95% CI: 1.5–3.4), had an increased incidence of major bleeding. With some variables available at entry we may identify those cancer patients withVTE at a higher risk for recurrences or major bleeding.

Keywords

Cancer - venous thromboembolism - bleeding - recurrences

Full Text

References

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