Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study
The risk factors for venous thromboembolism (VTE) recurrence/exacerbation or a change from a direct oral anticoagulant (DOAC) to another anticoagulant in patients with gynecologic cancer using DOACs have not been thoroughly elucidated. Here, we aimed to investigate the risk factors for a composite p...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/4/1132 |
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| author | Takanori Shimizu Noriyuki Iwama Hideki Tokunaga Shun Endo Shuko Miyahara Asami Toki Zen Watanabe Junko Minato Chiaki Hashimoto Masumi Ishibashi Shogo Shigeta Muneaki Shimada Nobuo Yaegashi |
| author_facet | Takanori Shimizu Noriyuki Iwama Hideki Tokunaga Shun Endo Shuko Miyahara Asami Toki Zen Watanabe Junko Minato Chiaki Hashimoto Masumi Ishibashi Shogo Shigeta Muneaki Shimada Nobuo Yaegashi |
| author_sort | Takanori Shimizu |
| collection | DOAJ |
| description | The risk factors for venous thromboembolism (VTE) recurrence/exacerbation or a change from a direct oral anticoagulant (DOAC) to another anticoagulant in patients with gynecologic cancer using DOACs have not been thoroughly elucidated. Here, we aimed to investigate the risk factors for a composite primary outcome, including VTE recurrence/exacerbation, or a change from a DOAC to another anticoagulant, in this population. A total of 63 patients were analyzed. Risk factors for a primary outcome within 2 years after DOAC initiation were investigated using multiple logistic regression analysis. Among the 63 patients, 10 developed a primary outcome. Clear cell carcinoma of the ovary (adjusted odds ratio (aOR), 18.9; 95% confidence interval (CI), 2.25–350.74), pulmonary embolism (PE) or proximal deep vein thrombosis without PE (aOR, 55.6; 95% CI, 3.29–11,774.66), and D-dimer levels in the third tertile (≥7.6 μg/dL) when VTE was first diagnosed (aOR, 6.37; 95% CI, 1.17–66.61) were associated with increased odds of a primary outcome in patients with gynecologic cancer using DOACs. Patients with one or more risk factors for a primary outcome require careful follow-up after DOAC initiation for the early recognition of treatment failure. |
| first_indexed | 2024-03-11T09:02:36Z |
| format | Article |
| id | doaj.art-0944d19cccef41258e61dce2eb86ed50 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:02:36Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-0944d19cccef41258e61dce2eb86ed502023-11-16T19:36:38ZengMDPI AGCancers2072-66942023-02-01154113210.3390/cancers15041132Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort StudyTakanori Shimizu0Noriyuki Iwama1Hideki Tokunaga2Shun Endo3Shuko Miyahara4Asami Toki5Zen Watanabe6Junko Minato7Chiaki Hashimoto8Masumi Ishibashi9Shogo Shigeta10Muneaki Shimada11Nobuo Yaegashi12Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanDepartment of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryomachi, Sendai 980-8574, JapanThe risk factors for venous thromboembolism (VTE) recurrence/exacerbation or a change from a direct oral anticoagulant (DOAC) to another anticoagulant in patients with gynecologic cancer using DOACs have not been thoroughly elucidated. Here, we aimed to investigate the risk factors for a composite primary outcome, including VTE recurrence/exacerbation, or a change from a DOAC to another anticoagulant, in this population. A total of 63 patients were analyzed. Risk factors for a primary outcome within 2 years after DOAC initiation were investigated using multiple logistic regression analysis. Among the 63 patients, 10 developed a primary outcome. Clear cell carcinoma of the ovary (adjusted odds ratio (aOR), 18.9; 95% confidence interval (CI), 2.25–350.74), pulmonary embolism (PE) or proximal deep vein thrombosis without PE (aOR, 55.6; 95% CI, 3.29–11,774.66), and D-dimer levels in the third tertile (≥7.6 μg/dL) when VTE was first diagnosed (aOR, 6.37; 95% CI, 1.17–66.61) were associated with increased odds of a primary outcome in patients with gynecologic cancer using DOACs. Patients with one or more risk factors for a primary outcome require careful follow-up after DOAC initiation for the early recognition of treatment failure.https://www.mdpi.com/2072-6694/15/4/1132D-dimerdirect oral anticoagulantsgynecologic cancerrisk factorsvenous thromboembolism |
| spellingShingle | Takanori Shimizu Noriyuki Iwama Hideki Tokunaga Shun Endo Shuko Miyahara Asami Toki Zen Watanabe Junko Minato Chiaki Hashimoto Masumi Ishibashi Shogo Shigeta Muneaki Shimada Nobuo Yaegashi Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study Cancers D-dimer direct oral anticoagulants gynecologic cancer risk factors venous thromboembolism |
| title | Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study |
| title_full | Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study |
| title_fullStr | Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study |
| title_full_unstemmed | Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study |
| title_short | Precautions during Direct Oral Anticoagulant Introduction in Gynecologic Malignancies: A Single-Center Retrospective Cohort Study |
| title_sort | precautions during direct oral anticoagulant introduction in gynecologic malignancies a single center retrospective cohort study |
| topic | D-dimer direct oral anticoagulants gynecologic cancer risk factors venous thromboembolism |
| url | https://www.mdpi.com/2072-6694/15/4/1132 |
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