Retrospective Cohort Analysis of Aspirin Use and Venous Thromboembolism in Patients with Pancreatic Cancer and an Indwelling Central Venous Catheter

King, Richard A.; Schaefer, Jordan K.; Sahai, Vaibhav; Griffith, Kent A.; Sood, Suman L.

doi:10.1055/s-0042-1747685

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…These findings were at odds with those of King et al (14) who claimed that cases who had ever taken aspirin had fewer VTE episodes than those who hadn't. While in another study Ahmed et al (15) showed that people using aspirin had a higher risk of developing VTE.…”

Section: Discussionmentioning

confidence: 62%

Validity of Modified Vienna-CATS Score for Prediction of Venous Thromboembolism in Egyptian Cancer Cases

El-sayed

Ebrahim²,

Ghoneim³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Modern oncology has a compelling problem in predicting the hazards of venous thromboembolism (VTE) linked with chemotherapy. Although thromboprophylaxis is not now advised for primary prevention, it is typically advised that cases' risks of VTE be evaluated before treatment. Great interest was given to establishing effective predictive methods for VTE in cancer cases. The aim of this study:The study aimed to detect whether Egyptian cancer cases' VTE risk could be predicted using the modified Vienna Cancer and Thrombosis Study (CATS) score. Methods: 214 newly diagnosed cancer cases participated in a prospective cohort study completed before receiving chemotherapy. Cases who received chemotherapy were monitored for VTE episodes for six months. The Khorana score was determined. D dimer and soluble P-selectin (sP-selectin) levels were assessed, followed by a modified Vienna CATS score. For each example, the Vienna CATS score was determined. Results: Only 24 (11.2%) of the 214 cases who had follow-up experienced VTE episodes, and 5 of these (2.3%) were lost. Conclusion:When compared to the Khorana score, the modified Vienna CATS score was more sensitive in identifying cancer cases at risk for VTE. Implementation of modified Vienna CATS in the clinical workup of cancer cases could help physicians to tailor antithrombotic therapy and lead to the perfect use of thromboprophylaxis.

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Section: Discussionmentioning

confidence: 62%

Validity of Modified Vienna-CATS Score for Prediction of Venous Thromboembolism in Egyptian Cancer Cases

El-sayed

Ebrahim²,

Ghoneim³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…More than half of the patients included in this study were smokers, and a significant portion had comorbid conditions. Active smoking was previously associated with VTE events in patients with cancer [22].…”

Section: Discussionmentioning

confidence: 93%

“…For example, one study found that only 37% of patients prescribed LMWHs and 61% of patients prescribed oral agents were still continuing those treatments at 6 months [1]. In another study, it was shown that patients with any aspirin use had fewer VTE events (34.4%) compared to those without aspirin use [22]. In the study conducted by Akay et al, venous thrombosis in an upper extremity was commonly seen in cancer patients and treatment of DVT via DOACs was found to be more effective than LMWHs in preventing recurrent VTE (risk ratio: 0.111; 95% CI: 0.014-0.866) [35].…”

Section: Discussionmentioning

confidence: 99%

Assessment of patient characteristics in cancer-associated venous thrombosis in Türkiye (CAT-TR study)

Unal,

Akay,

Dogancı

et al. 2023

Turk J Vasc Surg

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Aim: In cancer patients, the overall risk of venous thromboembolism (VTE) is increased 7-fold, and in cases of certain malignancies, this risk increases to 28-fold. The main objectives of this study are to describe patterns of use of anticoagulants for the treatment of cancer-related VTE in Türkiye and to assess patient characteristics. Material and Methods: This was a multicenter, retrospective, descriptive study utilizing data from 17 centers across Türkiye. We included 2936 patients with a diagnosis of any cancer and a diagnosis of proximal lower-limb deep vein thrombosis (DVT) and/or pulmonary embolism (PE) between January 1, 2016, and December 31, 2019. These patients were only included if the cancer diagnosis was made at least 6 months before the diagnosis of VTE or within 30 days following the diagnosis of VTE. Patients were followed from the day after the index date until the earliest date among the dates of death, the end of the study, or the end of the 6-month treatment period. Results: The study included 2796 patients with VTE between 2016 and 2019. While 41.4% of the participants were female, 58.6% were male, and 66.1% of the patients had DVT while 45.2% had PE. Furthermore, 52.7% had a history of smoking and only three patients had known hereditary thrombophilia. Lung cancer was the most common type of cancer, diagnosed in 872 patients (29.3%), followed by colon cancer diagnosed in 255 patients (8.6%) and breast cancer diagnosed in 202 patients (6.8%). Among these patients, 70.3% were in an advanced stage of the disease. Chemotherapy was administered to 469 (65.7%) patients at the time of disease onset. Among the patients with VTE, 99.5% were treated, and low-molecular-weight heparin was used in 97.5% of these cases while 3% of the patients were treated with direct oral anticoagulants. Bleeding was observed in 1.6% of the patients who participated in this study, and 39.1% of the bleeding events whose type was specified were categorized as major bleeding. Bleeding was most intense in the gastrointestinal tract (56.7%). Recurrence was observed in 1.5% of the patients and improvement was observed in 42.1%. In the first 6 months after diagnosis, 14.3% of the patients died. Causes of mortality could not be obtained from the patients’ records. Conclusion: VTE is common in patients with active cancer and associated with high recurrence and mortality rates. Efforts are needed to prevent VTE, diagnose it in time, and reduce the recurrence rates, especially in the first year after VTE diagnosis.

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“…A retrospective cohort study of patients with PDAC treated with chemotherapy using a central venous catheter compared VTE incidence in 125 PDAC patients treated with aspirin to 189 patients with no aspirin treatment. 103 Patients treated with aspirin had fewer VTE events than patients not using aspirin (34 vs. 42%, p ¼ 0.021), while major bleeding and clinically relevant minor bleeding complication rates were similar. 103 Platelet aggregation inhibition (e.g., by aspirin treatment) might be an effective therapeutic strategy in the prevention of VTE in patients with PDAC, but a randomized clinical trial is required to evaluate this strategy.…”

Section: Plateletsmentioning

confidence: 90%

“…103 Patients treated with aspirin had fewer VTE events than patients not using aspirin (34 vs. 42%, p ¼ 0.021), while major bleeding and clinically relevant minor bleeding complication rates were similar. 103 Platelet aggregation inhibition (e.g., by aspirin treatment) might be an effective therapeutic strategy in the prevention of VTE in patients with PDAC, but a randomized clinical trial is required to evaluate this strategy.…”

Section: Plateletsmentioning

confidence: 90%

Cellular Components Contributing to the Development of Venous Thrombosis in Patients with Pancreatic Cancer

Willems,

Biesmans,

Campello

et al. 2023

Semin Thromb Hemost

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Pancreatic ductal adenocarcinoma (PDAC) is an aggressive type of cancer and has a poor prognosis. Patients with PDAC are at high risk of developing thromboembolic events, which is a leading cause of morbidity and mortality following cancer progression. Plasma-derived coagulation is the most studied process in cancer-associated thrombosis. Other blood components, such as platelets, red blood cells, and white blood cells, have been gaining less attention. This narrative review addresses the literature on the role of cellular components in the development of venous thromboembolism (VTE) in patients with PDAC. Blood cells seem to play an important role in the development of VTE. Altered blood cell counts, i.e., leukocytosis, thrombocytosis, and anemia, have been found to associate with VTE risk. Tumor-related activation of leukocytes leads to the release of tissue factor-expressing microvesicles and the formation of neutrophil extracellular traps, initiating coagulation and forming a scaffold for thrombi. Tissue factor-expressing microvesicles are also thought to be released by PDAC cells. PDAC cells have been shown to stimulate platelet activation and aggregation, proposedly via the secretion of podoplanin and mucins. Hypofibrinolysis, partially explained by increased plasminogen activator inhibitor-1 activity, is observed in PDAC. In short, PDAC-associated hypercoagulability is a complex and multifactorial process. A better understanding of cellular contributions to hypercoagulability might lead to the improvement of diagnostic tests to identify PDAC patients at highest risk of VTE.

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Retrospective Cohort Analysis of Aspirin Use and Venous Thromboembolism in Patients with Pancreatic Cancer and an Indwelling Central Venous Catheter

Cited by 4 publications

References 27 publications

Validity of Modified Vienna-CATS Score for Prediction of Venous Thromboembolism in Egyptian Cancer Cases

Validity of Modified Vienna-CATS Score for Prediction of Venous Thromboembolism in Egyptian Cancer Cases

Assessment of patient characteristics in cancer-associated venous thrombosis in Türkiye (CAT-TR study)

Cellular Components Contributing to the Development of Venous Thrombosis in Patients with Pancreatic Cancer

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