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

Ording, Anne Gulbech, Nielsen, Peter Brønnum, Skjøth, Flemming, Overvad, Thure Filskov, Noble, Simon ORCID: https://orcid.org/0000-0001-5425-2383, Lash, Timothy L., Goldhaber, Samuel Zachery, Christensen, Thomas Decker, Larsen, Torben Bjerregaard and Søgaard, Mette 2023. Risk of recurrent cancer-associated venous thromboembolism: A Danish nationwide cohort study. International Journal of Cardiology 390 , 131271. 10.1016/j.ijcard.2023.131271

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Abstract

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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	0167-5273
Date of First Compliant Deposit:	5 October 2023
Date of Acceptance:	14 August 2023
Last Modified:	11 Oct 2023 19:23
URI:	https://orca.cardiff.ac.uk/id/eprint/162976

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