Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study)

Cancers

Macarena Real-Domínguez¹  Emilio García-Cabrera²  Francisco Javier Rodríguez-Martorell³  Pilar Medina⁴  Julia Oto⁴  Elena Arellano⁵  Verónica Sánchez-López⁵  Isabel Blasco-Esquivias⁶  María Rodríguez de la Borbolla⁷  Luis Jara-Palomares⁸  Remedios Otero⁸  Samira Marín⁸  Teresa Elías⁸  María Isabel Asencio⁸  José María Sánchez-Díaz⁸  Aurora Solier-López⁸ 

[1] Departamento de Medicina Preventiva y Salud Pública, Universidad de Málaga, 29071 Málaga, Spain;Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, 41009 Seville, Spain;Department of Hematology, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain;Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnic Hospital, 46026 Valencia, Spain;Instituto de Biomedicina de Sevilla (IBiS), Consejo Superior de Investigaciones Cientificas (CSIC), Universidad de Sevilla, 41013 Sevilla, Spain;Internal Medicine, Emergency Service, Virgen Macarena Hospital, 41009 Seville, Spain;Medical Oncology, Virgen de Valme Hospital, 41014 Seville, Spain;Medical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain;

关键词: biomarkers;    venous thromboembolism;    recurrence;    cancer;    cancer-associated thrombosis;   

DOI  :  10.3390/cancers14112771

来源: DOAJ

【 摘 要 】

The most appropriate duration of anticoagulant treatment for cancer-associated venous thromboembolism (CAT) remains unclear. We have conducted a prospective multicenter study in CAT patients with more than 6 months of anticoagulant treatment to predict the risk of venous thromboembolism (VTE) recurrence after anticoagulation discontinuation. Blood samples were obtained when patients stopped the anticoagulation, at 21 days and at 90 days. In each sample we assessed different coagulation-related biomarkers: D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP), P-selectin (PS), phospholipids, soluble tissue factor, factor VIII and the thrombin generation test. It was evaluated 325 CAT patients and 166 patients were included in the study, mean age 64 ± 17 years. VTE recurrence until 6 months after stopping anticoagulation treatment was 9.87% [95% confidence interval (CI): 6–15]. The biomarkers sub-distribution hazard ratios were 6.32 for ratio DD basal/DD 21 days > 2 (95% CI: 1.82–21.90), 6.36 for hs-CRP > 4.5 (95% CI: 1.73–23.40) and 5.58 for PS > 40 (95% CI: 1.46–21.30) after 21 days of stopping anticoagulation. This is the first study that has identified the DD ratio, hs-CRP and PS as potential biomarkers of VTE recurrence in cancer patients after the discontinuation of anticoagulation treatment. A risk-adapted strategy may allow the identification of the optimal time to withdraw the anticoagulation in each CAT patient.

【 授权许可】

Unknown