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Cancer effect on periprocedural thromboembolism and bleeding in anticoagulated patients.
Tafur, A J; Wysokinski, W E; McBane, R D; Wolny, E; Sutkowska, E; Litin, S C; Daniels, P R; Slusser, J P; Hodge, D O; Heit, J A.
Afiliación
  • Tafur AJ; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester.
  • Wysokinski WE; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester. Electronic address: wysokinski.waldemar@mayo.edu.
  • McBane RD; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester.
  • Wolny E; Department of Radiotherapy, Memorial Regional Hospital, Zielona Gora.
  • Sutkowska E; Division of Rehabilitation, Department of Orthopedic Surgery, University Medical School of Wroclaw, Wroclaw, Poland.
  • Litin SC; General Internal Medicine, Department of Internal Medicine.
  • Daniels PR; General Internal Medicine, Department of Internal Medicine.
  • Slusser JP; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, USA.
  • Hodge DO; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, USA.
  • Heit JA; Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester.
Ann Oncol ; 23(8): 1998-2005, 2012 Aug.
Article en En | MEDLINE | ID: mdl-22473596
BACKGROUND: Patients with active cancer are often on chronic anticoagulation and frequently require interruption of this treatment for invasive procedures. The impact of cancer on periprocedural thromboembolism (TE) and major bleeding is not known. PATIENTS AND METHODS: Two thousand one hundred and eighty-two consecutive patients referred for periprocedural anticoagulation (2484 procedures) using a standardized protocol were followed forward in time to estimate the 3-month incidence of TE, major bleeding and survival stratified by anticoagulation indication. For each indication, we tested active cancer and bridging heparin therapy as potential predictors of TE and major bleeding. RESULTS: Compared with patients without cancer, active cancer patients (n=493) had more venous thromboembolism (VTE) complications (1.2% versus 0.2%; P=0.001), major bleeding (3.4% versus 1.7%; P=0.02) and reduced survival (95% versus 99%; P<0.001). Among active cancer patients, only those chronically anticoagulated for VTE had higher rates of periprocedural VTE (2% versus 0.16%; P=0.002) and major bleeding (3.7% versus 0.6%; P<0.001). Bridging with heparin increased the rate of major bleeding in cancer patients (5% versus 1%; P=0.03) without impacting the VTE rate (0.7% versus 1.4%, P=0.50). CONCLUSIONS: Cancer patients anticoagulated for VTE experience higher rates of periprocedural VTE and major bleeding. Periprocedural anticoagulation for these patients requires particular attention to reduce these complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / Hemorragia / Anticoagulantes / Neoplasias Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Oncol Asunto de la revista: NEOPLASIAS Año: 2012 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / Hemorragia / Anticoagulantes / Neoplasias Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Oncol Asunto de la revista: NEOPLASIAS Año: 2012 Tipo del documento: Article Pais de publicación: Reino Unido