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D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis

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) recur...

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Detalles Bibliográficos
Autores principales: Jara-Palomares, Luis, Solier-Lopez, Aurora, Elias-Hernandez, Teresa, Asensio-Cruz, Maria Isabel, Blasco-Esquivias, Isabel, Sanchez-Lopez, Veronica, de la Borbolla, Maria Rodriguez, Arellano-Orden, Elena, Suarez-Valdivia, Lionel, Marin-Romero, Samira, Marin-Barrera, Lucia, Ruiz-Garcia, Aranzazu, Montero-Romero, Emilio, Navarro-Herrero, Silvia, Lopez-Campos, Jose Luis, Serrano-Gotarredona, Maria Pilar, Praena-Fernandez, Juan Manuel, Sanchez-Diaz, Jose Maria, Otero-Candelera, Remedios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203717/
https://www.ncbi.nlm.nih.gov/pubmed/30318508
http://dx.doi.org/10.1038/s41416-018-0269-5
Descripción
Sumario: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.