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Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice

Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retro...

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Autores principales: Ogino, Yutaka, Ishigami, Tomoaki, Sato, Ryosuke, Nakahashi, Hidefumi, Minamimoto, Yugo, Kimura, Yuichiro, Okada, Kozo, Matsuzawa, Yasushi, Iwahashi, Noriaki, Hibi, Kiyoshi, Kosuge, Masami, Ebina, Toshiaki, Ishikawa, Toshiyuki, Tamura, Kouichi, Kimura, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539627/
https://www.ncbi.nlm.nih.gov/pubmed/34682770
http://dx.doi.org/10.3390/jcm10204648
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author Ogino, Yutaka
Ishigami, Tomoaki
Sato, Ryosuke
Nakahashi, Hidefumi
Minamimoto, Yugo
Kimura, Yuichiro
Okada, Kozo
Matsuzawa, Yasushi
Iwahashi, Noriaki
Hibi, Kiyoshi
Kosuge, Masami
Ebina, Toshiaki
Ishikawa, Toshiyuki
Tamura, Kouichi
Kimura, Kazuo
author_facet Ogino, Yutaka
Ishigami, Tomoaki
Sato, Ryosuke
Nakahashi, Hidefumi
Minamimoto, Yugo
Kimura, Yuichiro
Okada, Kozo
Matsuzawa, Yasushi
Iwahashi, Noriaki
Hibi, Kiyoshi
Kosuge, Masami
Ebina, Toshiaki
Ishikawa, Toshiyuki
Tamura, Kouichi
Kimura, Kazuo
author_sort Ogino, Yutaka
collection PubMed
description Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. In these patients, 200 patients with cancer-associated IDDVT were evaluated. Results: Mean follow-up period was 780 ± 593 days. Major bleeding and VTE recurrence were observed in 22 (11.0%) and 11 (5.5%) patients, respectively. In multivariate analysis, statistically significant factors correlated with major bleeding were advanced cancer stage, high performance status, stomach cancer, and gallbladder cancer; those correlated with all-cause death were advanced cancer stage, high performance status, liver dysfunction, pancreatic cancer, and major bleeding. Cumulative events of major bleeding and recurrence between patients with prolonged DOAC therapy (≥90 days) and those with nonprolonged therapy were not significantly different. Conclusions: Preventing major bleeding is important because it is a significant risk factor for all-cause death. Major bleeding and recurrent events were comparable between prolonged and nonprolonged therapy.
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spelling pubmed-85396272021-10-24 Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice Ogino, Yutaka Ishigami, Tomoaki Sato, Ryosuke Nakahashi, Hidefumi Minamimoto, Yugo Kimura, Yuichiro Okada, Kozo Matsuzawa, Yasushi Iwahashi, Noriaki Hibi, Kiyoshi Kosuge, Masami Ebina, Toshiaki Ishikawa, Toshiyuki Tamura, Kouichi Kimura, Kazuo J Clin Med Article Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. In these patients, 200 patients with cancer-associated IDDVT were evaluated. Results: Mean follow-up period was 780 ± 593 days. Major bleeding and VTE recurrence were observed in 22 (11.0%) and 11 (5.5%) patients, respectively. In multivariate analysis, statistically significant factors correlated with major bleeding were advanced cancer stage, high performance status, stomach cancer, and gallbladder cancer; those correlated with all-cause death were advanced cancer stage, high performance status, liver dysfunction, pancreatic cancer, and major bleeding. Cumulative events of major bleeding and recurrence between patients with prolonged DOAC therapy (≥90 days) and those with nonprolonged therapy were not significantly different. Conclusions: Preventing major bleeding is important because it is a significant risk factor for all-cause death. Major bleeding and recurrent events were comparable between prolonged and nonprolonged therapy. MDPI 2021-10-11 /pmc/articles/PMC8539627/ /pubmed/34682770 http://dx.doi.org/10.3390/jcm10204648 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ogino, Yutaka
Ishigami, Tomoaki
Sato, Ryosuke
Nakahashi, Hidefumi
Minamimoto, Yugo
Kimura, Yuichiro
Okada, Kozo
Matsuzawa, Yasushi
Iwahashi, Noriaki
Hibi, Kiyoshi
Kosuge, Masami
Ebina, Toshiaki
Ishikawa, Toshiyuki
Tamura, Kouichi
Kimura, Kazuo
Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title_full Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title_fullStr Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title_full_unstemmed Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title_short Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice
title_sort direct oral anticoagulant therapy for isolated distal deep vein thrombosis associated with cancer in routine clinical practice
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539627/
https://www.ncbi.nlm.nih.gov/pubmed/34682770
http://dx.doi.org/10.3390/jcm10204648
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