D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.

Jara-Palomares, LuisSolier-Lopez, AuroraElias-Hernandez, TeresaAsensio-Cruz, Maria IsabelBlasco-Esquivias, IsabelSanchez-Lopez, Veronicade la Borbolla, Maria RodriguezArellano-Orden, ElenaSuarez-Valdivia, LionelMarin-Romero, SamiraMarin-Barrera, LuciaRuiz-Garcia, AranzazuMontero-Romero, EmilioNavarro-Herrero, SilviaLopez-Campos, Jose LuisSerrano-Gotarredona, Maria PilarPraena-Fernandez, Juan ManuelSanchez-Diaz, Jose MariaOtero-Candelera, Remedios2023-01-252023-01-252018-10-15http://hdl.handle.net/10668/13079Optimal 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AnticoagulantsC-Reactive ProteinDrug Administration ScheduleFemaleFibrin Fibrinogen Degradation ProductsHumansMaleMiddle AgedNeoplasmsProspective StudiesRecurrenceRisk AssessmentRisk FactorsSecondary PreventionVenous ThromboembolismVenous ThrombosisWithholding TreatmentD-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.research article30318508open access10.1038/s41416-018-0269-51532-1827PMC6203717https://www.nature.com/articles/s41416-018-0269-5.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203717/pdf