Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study)
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) recurr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/11/2771 |
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| author | Remedios Otero Aurora Solier-López Verónica Sánchez-López Julia Oto Elena Arellano Samira Marín Luis Jara-Palomares Teresa Elías María Isabel Asencio Isabel Blasco-Esquivias María Rodríguez de la Borbolla José María Sánchez-Díaz Macarena Real-Domínguez Emilio García-Cabrera Francisco Javier Rodríguez-Martorell Pilar Medina |
| author_facet | Remedios Otero Aurora Solier-López Verónica Sánchez-López Julia Oto Elena Arellano Samira Marín Luis Jara-Palomares Teresa Elías María Isabel Asencio Isabel Blasco-Esquivias María Rodríguez de la Borbolla José María Sánchez-Díaz Macarena Real-Domínguez Emilio García-Cabrera Francisco Javier Rodríguez-Martorell Pilar Medina |
| author_sort | Remedios Otero |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T01:26:09Z |
| format | Article |
| id | doaj.art-afdb80fa11844ed884d2a7e4ceded9b9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T01:26:09Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-afdb80fa11844ed884d2a7e4ceded9b92023-11-23T13:50:53ZengMDPI AGCancers2072-66942022-06-011411277110.3390/cancers14112771Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study)Remedios Otero0Aurora Solier-López1Verónica Sánchez-López2Julia Oto3Elena Arellano4Samira Marín5Luis Jara-Palomares6Teresa Elías7María Isabel Asencio8Isabel Blasco-Esquivias9María Rodríguez de la Borbolla10José María Sánchez-Díaz11Macarena Real-Domínguez12Emilio García-Cabrera13Francisco Javier Rodríguez-Martorell14Pilar Medina15Medical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainInstituto de Biomedicina de Sevilla (IBiS), Consejo Superior de Investigaciones Cientificas (CSIC), Universidad de Sevilla, 41013 Sevilla, SpainHaemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnic Hospital, 46026 Valencia, SpainInstituto de Biomedicina de Sevilla (IBiS), Consejo Superior de Investigaciones Cientificas (CSIC), Universidad de Sevilla, 41013 Sevilla, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainInternal Medicine, Emergency Service, Virgen Macarena Hospital, 41009 Seville, SpainMedical Oncology, Virgen de Valme Hospital, 41014 Seville, SpainMedical Surgical Unit of Respiratory Diseases, Hospital Universitario Virgen del Rocío, 41013 Seville, SpainDepartamento de Medicina Preventiva y Salud Pública, Universidad de Málaga, 29071 Málaga, SpainDepartamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, 41009 Seville, SpainDepartment of Hematology, Hospital Universitario Virgen del Rocio, 41013 Seville, SpainHaemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnic Hospital, 46026 Valencia, SpainThe 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.https://www.mdpi.com/2072-6694/14/11/2771biomarkersvenous thromboembolismrecurrencecancercancer-associated thrombosis |
| spellingShingle | Remedios Otero Aurora Solier-López Verónica Sánchez-López Julia Oto Elena Arellano Samira Marín Luis Jara-Palomares Teresa Elías María Isabel Asencio Isabel Blasco-Esquivias María Rodríguez de la Borbolla José María Sánchez-Díaz Macarena Real-Domínguez Emilio García-Cabrera Francisco Javier Rodríguez-Martorell Pilar Medina Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) Cancers biomarkers venous thromboembolism recurrence cancer cancer-associated thrombosis |
| title | Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) |
| title_full | Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) |
| title_fullStr | Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) |
| title_full_unstemmed | Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) |
| title_short | Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study) |
| title_sort | biomarkers of venous thromboembolism recurrence after discontinuation of low molecular weight heparin treatment for cancer associated thrombosis hispalis study |
| topic | biomarkers venous thromboembolism recurrence cancer cancer-associated thrombosis |
| url | https://www.mdpi.com/2072-6694/14/11/2771 |
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