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Thromb Haemost 2011; 105(06): 962-967
DOI: 10.1160/TH11-01-0002
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Long-term anticoagulation treatment for acute venous thromboembolism in patients with and without cancer

The SWIss Venous ThromboEmbolism Registry (SWIVTER) II
David Spirk
1   Medical Affairs, Sanofi-Aventis (Suisse) SA, Meyrin, Switzerland
,
Jörg Ugi
2   Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland
,
Wolfgang Korte
3   Department of Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
,
Marc Husmann
4   Clinic of Angiology, University Hospital Zurich, Zurich, Switzerland
,
Daniel Hayoz
5   Department of Internal Medicine, Cantonal Hospital Fribourg, Fribourg, Switzerland
,
Thomas Baldi
6   Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
,
Beat Frauchiger
7   Department of Internal Medicine, Cantonal Hospital Frauenfeld, Frauenfeld, Switzerland
,
Martin Banyai
8   Department of Internal Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland
,
Drahomir Aujesky
9   Division of General Internal Medicine, University Hospital Bern, Bern, Switzerland
,
Iris Baumgartner
2   Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland
,
Nils Kucher
2   Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland
› Author Affiliations Financial support:This study was funded by Sanofi-Aventis (Suisse) SA, Meyrin, Switzerland.
Further Information

Publication History

Received: 02 January 2011

Accepted after minor revision: 04 February 2011

Publication Date:
28 November 2017 (online)

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Summary

In patients with acute cancer-associated thrombosis, current consensus guidelines recommend anticoagulation therapy for an indefinite duration or until the cancer is resolved. Among 1,247 patients with acute venous thromboembolism (VTE) enrolled in the prospective Swiss Venous Thromboembolism Registry (SWIVTER) II from 18 hospitals, 315 (25%) had cancer of whom 179 (57%) had metastatic disease, 159 (50%) ongoing or recent chemotherapy, 83 (26%) prior cancer surgery, and 63 (20%) recurrent VTE. Long-term anticoagulation treatment for >12 months was more often planned in patients with versus without cancer (47% vs. 19%; p<0.001), with recurrent cancer-associated versus first cancer-associated VTE (70% vs. 41%; p<0.001), and with metastatic versus non-metastatic cancer (59% vs. 31%; p<0.001). In patients with cancer, recurrent VTE (OR 3.46; 95%CI 1.83–6.53), metastatic disease (OR 3.04; 95%CI 1.86–4.97), and the absence of an acute infection (OR 3.55; 95%CI 1.65–7.65) were independently associated with the intention to maintain anticoagulation for >12 months. In conclusion, long-term anticoagulation treatment for more than 12 months was planned in less than half of the cancer patients with acute VTE. The low rates of long-term anticoagulation in cancer patients with a first episode of VTE and in patients with non-metastatic cancer require particular attention.

Keywords

Anticoagulation - cancer - venous thromboembolism
 

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