Racial and Ethnic Disparities in Cancer-Associated Thrombosis

Wiredu, Courteney; Haynes, Norrisa; Guerra, Carmen E.; Ky, Bonnie

doi:10.1055/a-1674-0259

Cited by 14 publications

(12 citation statements)

References 19 publications

(43 reference statements)

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“…This difference underlines the relevance of estimating the occurrence of VTE events in different populations since ethnic variation can alter the rate of this outcome. Previous studies have described that cancer patients of Hispanic background are at higher risk of mortality due to pulmonary embolism in comparison with White individuals [12][13][14]; however, these analyses have also reported that Hispanic patients have lower rates of VTE than White and Caucasian populations. These contradictory results can be explained by several reasons.…”

Section: Discussionmentioning

confidence: 91%

“…Although the KRS has been validated in several populations [5,[9][10][11], we found scarce data regarding the prognostic value of this tool among Hispanic patients from Latin American countries. Indeed, previous studies have described that Hispanic patients have a higher incidence of VTE in comparison to non-Hispanic Whites and Asian individuals, but a lower frequency of VTE in comparison to African American patients [12][13][14]. Moreover, recent studies have associated the KRS as a prognostic variable for overall survival (OS) in cancer patients, but most of these analyses have been carried out in different populations other than Hispanics [3].…”

Section: Introductionmentioning

confidence: 99%

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Using the Khorana risk score to predict venous thromboembolism and overall survival in a cohort of Hispanic patients with solid malignancies

Ramos-Esquivel¹,

Marenco-Flores²,

Hernández-Romero³

et al. 2022

ecancer

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Background:The Khorana risk score (KRS) for prognosis of venous thromboembolism (VTE) has been rarely explored in Hispanic populations.Objective: To determine the value of the KRS for prediction of VTE and overall survival (OS) among Hispanic individuals with cancer. Methods:We retrospectively evaluated all outpatients with newly diagnosed solid tumours receiving systemic chemotherapy in Hospital San Juan Dios, San José, Costa Rica, from January to December 2021. The 6-month cumulative VTE incidence according to the KRS categories was estimated using the Fine & Gray competing risk model. A Kaplan-Meier analysis was used to compare OS among KRS categories. The Cox regression analysis was performed to calculate the hazard ratio (HR) and its corresponding 95% confidence interval (CI). The receiver operating characteristic (ROC) analysis was performed to identify the optimal cutoff value to predict VTE during follow-up.Results: A total of 708 patients were included in the analysis. After a median followup of 8.13 months, the cumulative incidence of VTE at 6 months was 1.56% (95% CI: 0.83%-6.82%), 4.83% (95% CI: 2.81%-7.66%) and 8.84% (95% CI: 4.30%-15.42%) for low-, intermediate-and high-risk Khorana score categories, respectively (Gray's p value: 0.0178). The optimal cutoff for the KRS to predict VTE was 2 (area under the ROC curve: 0.65; 95% CI: 0.55-0.756). The KRS was independently associated with overall mortality (HR: 1.83; 95% CI: 1.46-2.29; p < 0.001, for the comparison of 'high-risk' and 'low-risk' KRS). Conclusions:The KRS is a valid tool to predict VTE and mortality in a cohort of Hispanic outpatients with newly diagnosed solid tumours.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Using the Khorana risk score to predict venous thromboembolism and overall survival in a cohort of Hispanic patients with solid malignancies

Ramos-Esquivel¹,

Marenco-Flores²,

Hernández-Romero³

et al. 2022

ecancer

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“…We found that there is an increased risk of VTE in blacks and Hispanics compared to whites. This may be attributed to socioeconomic factors, access to healthcare, and racial disparities, such as blacks being less likely to receive direct oral anticoagulants [ 10 ]. Although blacks have a lower prevalence of factor V Leiden and other coagulation disorders compared to whites, they still maintain a higher risk.…”

Section: Discussionmentioning

confidence: 99%

Risk Factor Analysis of Venous Thromboembolism in Cancer: A National Inpatient Sample Study

Rijal¹,

Kaur²,

Loh³

et al. 2022

Cureus

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Objective In this study, we aimed to explore the association of demographic characteristics and comorbidities with the risk of venous thromboembolism (VTE) in cancer inpatients, as well as to delineate the mortality risk in cancer inpatients with VTE. Methods We conducted a retrospective cohort analysis based on the National Inpatient Sample (NIS) 2012-2014, involving 339,395 inpatients with a primary diagnosis of cancer subdivided into cohorts without VTE (n=331,695) and with VTE (n=7,700). We used a binomial logistic regression model to evaluate the odds ratio (OR) of demographics, comorbidities, and in-hospital mortality rate with respect to cancer inpatients with VTE. Results A higher proportion of cancer inpatients with VTE were 36-50 years in age (83.1%), male (50%), and of black (19.3%) and Hispanic ethnicity (17.2%) compared to the non-VTE cohort. The prevalence of comorbidities was higher in the VTE cohort, including HIV/AIDS, congestive heart failure (CHF), chronic pulmonary disease, diabetes, hypertension, and obesity. CHF demonstrated the highest risk of association with VTE (OR: 2.68, 95% CI: 2.30-3.12), followed by hypertension (OR: 1.23, 95% CI: 1.16-1.29), diabetes (OR: 1.16, 95% CI: 1.07-1.26), and chronic pulmonary disease (OR: 1.13, 95% CI: 1.05-1.22). Conversely, valvular diseases, obesity, and drug abuse were not significantly associated with VTE in cancer inpatients. The in-hospital mortality rate was higher in cancer inpatients with VTE (12% vs. 2.1%), thereby increasing the in-hospital mortality risk (OR: 3.87, 95% CI: 3.58-4.18). Conclusion VTE risk was significantly higher in cancer patients with comorbid CHF, hypertension, diabetes, and chronic pulmonary disease. The risk of all-cause in-hospital mortality was increased by four times in cancer inpatients with VTE.

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“…In Asian patients with cancer, there are few prospective studies on risk factors for, and an RPM of, CAT occurrence (12)(13)(14). Although the risk of CAT is lower in Asian people than in other ethnic groups (15)(16)(17), VTE risk is much higher than usual in patients with metastatic cancer who are receiving chemotherapy, and VTE is one of the major causes of death among them (14,18). The occurrence of VTE can also interrupt or delay essential treatment, worsen quality of life, and increase the use of health care resources, including Usefulness of blood biomarkers for predicting venous thromboembolism in Japanese patients with cancer hospitalization (19).…”

Section: Introductionmentioning

confidence: 99%

Usefulness of blood biomarkers for predicting venous thromboembolism in Japanese patients with cancer

et al. 2023

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Prospective studies on risk factors for the occurrence of venous thromboembolism (VTE) in Asian patients with cancer are limited. Therefore, the present study assessed risk factors for VTE, including multiple blood biomarkers and risk scores consisting of several risk factors, in Japanese patients receiving anticancer drug therapy. In this single-center, prospective, observational study, 200 patients with six types of cancer were enrolled and followed for 1 year to observe the occurrence of symptomatic or asymptomatic VTE. The present study evaluated risk factors, Khorana and Vienna cancer and thrombosis study (CATS) scores at enrollment, and longitudinal data on various blood biomarkers. A Vienna CATS score of ≥3 was significantly associated with VTE occurrence (HR, 2.8; 95% CI, 0.9-8.7; P=0.045). In multivariable analysis, there was a significant association between VTE and the presence of pancreatic cancer (HR, 3.2; 95% CI, 1.1-8.8; P=0.028) and high soluble fibrin (HR, 3.7; 95% CI, 1.1-7.8; P= 0.036). Covariate analysis using the propensity score also showed a significant association with hemoglobin dichotomized at <100 g/l (HR, 3.9; 95% CI, 1.1-14.0; P=0.034). Longitudinal data indicated that VTE was associated with soluble fibrin baseline values and an increase in D-dimer levels over time. The present results suggested that blood biomarkers are beneficial for predicting the risk of VTE in Japanese patients with cancer. The present study also provided novel evidence for the importance of measuring soluble fibrin in patients with cancer.

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Racial and Ethnic Disparities in Cancer-Associated Thrombosis

Cited by 14 publications

References 19 publications

Using the Khorana risk score to predict venous thromboembolism and overall survival in a cohort of Hispanic patients with solid malignancies

Using the Khorana risk score to predict venous thromboembolism and overall survival in a cohort of Hispanic patients with solid malignancies

Risk Factor Analysis of Venous Thromboembolism in Cancer: A National Inpatient Sample Study

Usefulness of blood biomarkers for predicting venous thromboembolism in Japanese patients with cancer

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