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

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Date

2022-06-02

Authors

Otero, Remedios
Solier-Lopez, Aurora
Sanchez-Lopez, Veronica
Oto, Julia
Arellano, Elena
Marín, Samira
Jara-Palomares, Luis
Elias, Teresa
Asencio, Maria Isabel
Blasco-Esquivias, Isabel

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MDPI AG
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Abstract

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.

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MeSH Terms

Humans
fibrin fragment D
C-Reactive Protein
Venous Thromboembolism
Factor VIII
Thrombin
Thromboplastin

DeCS Terms

Pacientes
Terapéutica
Proteína C-Reactiva
Biomarcadores
Neoplasias
Anticoagulantes
Fosfolípidos

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Keywords

biomarkers, cancer, cancer-associated thrombosis, recurrence, venous thromboembolism

Citation

Otero R, Solier-López A, Sánchez-López V, Oto J, Arellano E, Marín S, et al. Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study). Cancers (Basel). 2022 Jun 2;14(11):2771.