Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784588792790777856 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8539627 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT oginoyutaka directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT ishigamitomoaki directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT satoryosuke directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT nakahashihidefumi directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT minamimotoyugo directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT kimurayuichiro directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT okadakozo directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT matsuzawayasushi directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT iwahashinoriaki directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT hibikiyoshi directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT kosugemasami directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT ebinatoshiaki directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT ishikawatoshiyuki directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT tamurakouichi directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice AT kimurakazuo directoralanticoagulanttherapyforisolateddistaldeepveinthrombosisassociatedwithcancerinroutineclinicalpractice |