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Thromb Haemost 2008; 100(03): 435-439
DOI: 10.1160/TH08-02-0125
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Predicting recurrences or major bleeding in cancer patients with venous thromboembolism

Findings from the RIETE Registry
Javier Trujillo-Santos
1   Departament of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia, Spain
,
José Antonio Nieto
2   Department of Internal Medicine, Hospital Virgen de la Luz, Cuenca, Spain
,
Gregorio Tiberio
3   Department of Internal Medicine, Hospital Virgen del Camino, Pamplona, Spain
,
Andrea Piccioli
4   Medical and Surgical Science, Clinica Medica II, University of Padova, Padova, Italy
,
Pierpaolo Di Micco
5   Internal Medicine and Emergency Room, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy
,
Paolo Prandoni
4   Medical and Surgical Science, Clinica Medica II, University of Padova, Padova, Italy
,
Manuel Monreal
6   Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; for the RIETE Investigators
› Author AffiliationsFinancial support: The authors thank Sanofi-Aventis Spain for supporting this Registry with an unrestricted educational grant and the Registry Coordinating Center, S & H Medical Science Service, for their logistic and administrative support. The project has been partially supported by Red Respira from the Instituto Carlos III (RedRespira-ISCiii-RTIC-03/11).
Further Information

Publication History

Received 29 February 2008

Accepted after major revision 22 June 2008

Publication Date:
22 November 2017 (online)

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Summary

Cancer patients with acute venous thromboembolism (VTE) have an increased incidence of recurrences and bleeding complications while on anticoagulant therapy. Methods RIETE is an ongoing registry of consecutive patients with acute VTE. We tried to identify which cancer patients are at a higher risk for recurrent pulmonary embolism (PE), deep vein thrombosis (DVT) or major bleeding. Up to May 2007, 3, 805 cancer patients had been enrolled in RIETE. During the first three months of follow-up after the acute, index VTE event, 90 (2.4%) patients developed recurrent PE, 100 (2.6%) recurrent DVT, 156 (4.1%) had major bleeding. Forty patients (44%) died of the recurrent PE,46 (29%) of bleeding. On multivariate analysis, patients aged <65 years (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.9–4.9), with PE at entry (OR: 1.9; 95% CI: 1.2–3.1), or with <3 months from cancer diagnosis to VTE (OR: 2.0; 95% CI: 1.2–3.2) had an increased incidence of recurrent PE. Those aged <65 years (OR: 1.6; 95% CI: 1.0–2.4) or with <3 months from cancer diagnosis (OR: 2.4; 95% CI: 1.5–3.6) had an increased incidence of recurrent DVT. Finally, patients with immobility (OR: 1.8; 95% CI: 1.2–2.7), metastases (OR: 1.6; 95% CI: 1.1–2.3), recent bleeding (OR: 2.4; 95% CI: 1.1–5.1), or with creatinine clearance <30 ml/ min (OR: 2.2; 95% CI: 1.5–3.4), had an increased incidence of major bleeding. With some variables available at entry we may identify those cancer patients withVTE at a higher risk for recurrences or major bleeding.

Keywords

Cancer - venous thromboembolism - bleeding - recurrences
 

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