Your browser doesn't support javascript.
loading
Anticoagulation for the Prevention of Arterial Thromboembolism in Cancer Patients by Primary Tumor Site: A Systematic Review and Meta-Analysis of Randomized Trials.
Xu, Yan; Mallity, Caroline; Collins, Erin; Siegal, Deborah M; Wang, Tzu-Fei; Carrier, Marc.
Afiliación
  • Xu Y; Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada.
  • Mallity C; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
  • Collins E; Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada.
  • Siegal DM; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
  • Wang TF; Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada.
  • Carrier M; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Eur Heart J Cardiovasc Pharmacother ; 2024 Sep 13.
Article en En | MEDLINE | ID: mdl-39271464
ABSTRACT

AIMS:

Incidence of arterial thromboembolism (ATE) among ambulatory cancer patients varies by primary tumor site. However, it is unclear whether this alters the benefit-to-harm profile of prophylactic anticoagulation for ATE prevention. Therefore, we systematically evaluated the efficacy and safety of anticoagulants for ATE prevention among ambulatory cancer patients according to the primary tumor site. METHODS AND

RESULTS:

We conducted a systematic review using Medline, Embase, SCOPUS, and CENTRAL, and included randomized trials comparing prophylactic anticoagulation to no anticoagulation among ambulatory cancer patients who initiated tumor-directed systemic therapy. Incidence of symptomatic ATE (acute ischemic stroke, acute myocardial infarction or peripheral artery occlusion) and major bleeding, as well as risk differences (RDs) attributable to anticoagulation were meta-analyzed by primary tumor site using random-effects modeling. We included 10 randomized controlled trials with 9,875 patients with follow-up ranging from 3.3 to 68 (median 6.6) months. While prophylactic anticoagulation did not reduce ATE risks overall (RD -0.49%; 95% CI -0.49% to 0.01%; I2=0%), it conferred a protective effect among pancreatic cancer patients (RD -3.2%; 95%CI -5.7% to -0.8%; I2=0%) without a detectable increase in major bleeding (RD -1.4%; 95% CI -4.6% to 1.8%; I2=0%). Prophylactic anticoagulation was not associated with ATE risk reduction in other tumor sites.

CONCLUSION:

Based on available evidence, prophylactic anticoagulation did not reduce ATE risk among ambulatory cancer patients overall. However, we observed lower incidence of ATE among pancreatic cancer patients randomized to receive anticoagulation. Prophylactic anticoagulant use to reduce ATEs in pancreatic cancer should be evaluated in future research.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Cardiovasc Pharmacother Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Heart J Cardiovasc Pharmacother Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido