Repositori URV

Identificador: imarina:5651864

Handle: https://hdl.handle.net/20.500.11797/imarina5651864

Autors:
Jara-Palomares LSolier-Lopez AElias-Hernandez TAsensio-Cruz MBlasco-Esquivias ISanchez-Lopez Vde la Borbolla MArellano-Orden ESuarez-Valdivia LMarin-Romero SMarin-Barrera LRuiz-Garcia AMontero-Romero ENavarro-Herrero SLopez-Campos JSerrano-Gotarredona MPraena-Fernandez JSanchez-Diaz JOtero-Candelera R

Resum:
© 2018, Cancer Research UK. Background: Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. Methods: Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. Results: Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3–15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19–52) and 5.81 for DD (95% CI: 1.1–31.7). Conclusions: This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.