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