Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retro...
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/20/4648 |
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| author | Yutaka Ogino Tomoaki Ishigami Ryosuke Sato Hidefumi Nakahashi Yugo Minamimoto Yuichiro Kimura Kozo Okada Yasushi Matsuzawa Noriaki Iwahashi Kiyoshi Hibi Masami Kosuge Toshiaki Ebina Toshiyuki Ishikawa Kouichi Tamura Kazuo Kimura |
| author_facet | Yutaka Ogino Tomoaki Ishigami Ryosuke Sato Hidefumi Nakahashi Yugo Minamimoto Yuichiro Kimura Kozo Okada Yasushi Matsuzawa Noriaki Iwahashi Kiyoshi Hibi Masami Kosuge Toshiaki Ebina Toshiyuki Ishikawa Kouichi Tamura Kazuo Kimura |
| author_sort | Yutaka Ogino |
| collection | DOAJ |
| description | Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. In these patients, 200 patients with cancer-associated IDDVT were evaluated. Results: Mean follow-up period was 780 ± 593 days. Major bleeding and VTE recurrence were observed in 22 (11.0%) and 11 (5.5%) patients, respectively. In multivariate analysis, statistically significant factors correlated with major bleeding were advanced cancer stage, high performance status, stomach cancer, and gallbladder cancer; those correlated with all-cause death were advanced cancer stage, high performance status, liver dysfunction, pancreatic cancer, and major bleeding. Cumulative events of major bleeding and recurrence between patients with prolonged DOAC therapy (≥90 days) and those with nonprolonged therapy were not significantly different. Conclusions: Preventing major bleeding is important because it is a significant risk factor for all-cause death. Major bleeding and recurrent events were comparable between prolonged and nonprolonged therapy. |
| first_indexed | 2024-03-10T06:29:14Z |
| format | Article |
| id | doaj.art-cba65972c96844ed930774aa7d3b0d80 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T06:29:14Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cba65972c96844ed930774aa7d3b0d802023-11-22T18:40:54ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011020464810.3390/jcm10204648Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical PracticeYutaka Ogino0Tomoaki Ishigami1Ryosuke Sato2Hidefumi Nakahashi3Yugo Minamimoto4Yuichiro Kimura5Kozo Okada6Yasushi Matsuzawa7Noriaki Iwahashi8Kiyoshi Hibi9Masami Kosuge10Toshiaki Ebina11Toshiyuki Ishikawa12Kouichi Tamura13Kazuo Kimura14Department of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanDepartment of Cardiology, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Cardiology, Yokohama City University Hospital, Yokohama 236-0004, JapanDepartment of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, JapanBackground: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. In these patients, 200 patients with cancer-associated IDDVT were evaluated. Results: Mean follow-up period was 780 ± 593 days. Major bleeding and VTE recurrence were observed in 22 (11.0%) and 11 (5.5%) patients, respectively. In multivariate analysis, statistically significant factors correlated with major bleeding were advanced cancer stage, high performance status, stomach cancer, and gallbladder cancer; those correlated with all-cause death were advanced cancer stage, high performance status, liver dysfunction, pancreatic cancer, and major bleeding. Cumulative events of major bleeding and recurrence between patients with prolonged DOAC therapy (≥90 days) and those with nonprolonged therapy were not significantly different. Conclusions: Preventing major bleeding is important because it is a significant risk factor for all-cause death. Major bleeding and recurrent events were comparable between prolonged and nonprolonged therapy.https://www.mdpi.com/2077-0383/10/20/4648direct oral anticoagulantisolated distal deep vein thrombosiscancer |
| spellingShingle | Yutaka Ogino Tomoaki Ishigami Ryosuke Sato Hidefumi Nakahashi Yugo Minamimoto Yuichiro Kimura Kozo Okada Yasushi Matsuzawa Noriaki Iwahashi Kiyoshi Hibi Masami Kosuge Toshiaki Ebina Toshiyuki Ishikawa Kouichi Tamura Kazuo Kimura Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice Journal of Clinical Medicine direct oral anticoagulant isolated distal deep vein thrombosis cancer |
| title | Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice |
| title_full | Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice |
| title_fullStr | Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice |
| title_full_unstemmed | Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice |
| title_short | Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice |
| title_sort | direct oral anticoagulant therapy for isolated distal deep vein thrombosis associated with cancer in routine clinical practice |
| topic | direct oral anticoagulant isolated distal deep vein thrombosis cancer |
| url | https://www.mdpi.com/2077-0383/10/20/4648 |
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