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Risk of recurrent cancer-associated venous thromboembolism: A Danish nationwide cohort study

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  • Anne Gulbech Ording, Danish Center for Clinical Health Services Research, Aalborg Universitetshospital
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  • Peter Brønnum Nielsen, Aalborg Universitetshospital, Aalborg Universitet
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  • Flemming Skjøth, Aalborg Universitet, Aalborg Universitetshospital, Danmark
  • Thure Filskov Overvad, Aalborg Universitetshospital, Danmark
  • Simon Noble, Marie Curie Palliative Care Research Centre, Cardiff University
  • ,
  • Timothy L Lash
  • Samuel Zachery Goldhaber, Harvard University
  • ,
  • Thomas Decker Christensen
  • Torben Bjerregaard Larsen, Aalborg Universitetshospital, Aalborg Universitet
  • ,
  • Mette Søgaard, Aalborg Universitet, Aalborg Universitetshospital

BACKGROUND: Predictive factors for recurrent cancer-associated venous thromboembolism have been inconsistent across previous studies. To provide data for improved risk stratification, we described the risk of recurrent venous thromboembolism overall and across age, sex, calendar period, cancer type, Ottawa risk score, cancer stage, and cancer treatment in a nationwide cohort of patients with active cancer.

METHODS: Using Danish administrative registries, we identified a cohort of all adult patients with active cancer and a first-time diagnosis of venous thromboembolism during 2003-2018. We accounted for the competing risk of death and calculated absolute risks of recurrent venous thromboembolism at six months.

RESULTS: The population included 34,072 patients with active cancer and venous thromboembolism. Recurrence risks at six months were higher for patients with genitourinary cancer (6.5%), lung cancer (6.1%), gastrointestinal cancer (5.6%), brain cancer (5.2%), and hematological cancer (5.1%) than for patients with gynecological cancer (4.7%), breast cancer (4.1%), and other cancer types (4.8%). Recurrence risks were similar for men (5.2%) and women (4.9%), with and without chemotherapy (5.1%), across Ottawa risk score group (low: 5.0%; high: 5.1%) and across calendar periods but increased with increasing cancer stage. The overall six-month all-cause mortality risk was 26%, and highest for patients with lung cancer (49%) and lowest among breast cancer patients (4.1%).

CONCLUSIONS: Six-month recurrence risk after first-time cancer-associated venous thromboembolism was high and varied by cancer type and patient characteristics. Refining risk stratification for recurrence may improve decision-making regarding treatment duration after cancer-associated thromboembolism.

TidsskriftInternational Journal of Cardiology
Sider (fra-til)131271
StatusUdgivet - 2023

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Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

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