%0 Journal Article
%A Jara-Palomares, Luis
%A Solier-Lopez, Aurora
%A Elias-Hernandez, Teresa
%A Asensio-Cruz, Maria Isabel
%A Blasco-Esquivias, Isabel
%A Sanchez-Lopez, Veronica
%A de la Borbolla, Maria Rodriguez
%A Arellano-Orden, Elena
%A Suarez-Valdivia, Lionel
%A Marin-Romero, Samira
%A Marin-Barrera, Lucia
%A Ruiz-Garcia, Aranzazu
%A Montero-Romero, Emilio
%A Navarro-Herrero, Silvia
%A Lopez-Campos, Jose Luis
%A Serrano-Gotarredona, Maria Pilar
%A Praena-Fernandez, Juan Manuel
%A Sanchez-Diaz, Jose Maria
%A Otero-Candelera, Remedios
%T D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.
%D 2018
%U http://hdl.handle.net/10668/13079
%X Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3-15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19-52) and 5.81 for DD (95% CI: 1.1-31.7). This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.
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