Abstract:

Background: Despite advances in cancer and venous thromboembolism (VTE) management, the epidemiology of cancer-associated thrombosis management over time remains unclear.

Objectives: We analyzed data from the RIETE registry spanning 2001 and 2020 to investigate temporal trends in clinical characteristics and treatments for cancer-associated thrombosis.

Methods: Using multivariable survival regression, we examined temporal trends in risk-adjusted rates of symptomatic VTE recurrences, major bleeding, and death within 30 days after incident VTE.

Results: Among the 17,271 patients with cancer-associated thrombosis, there was a progressive increase in patients presenting with pulmonary embolism (from 44% in 2001-2005 to 55% in 2016-2020; p <0.001 for trend), lung (from 12.7% to 18.1%; p <0.001), or pancreatic cancer (from 3.8% to 5.6%; p=0.003), and the utilization of immunotherapy (from 0 to 7.4%; p <0.001). Conversely, there was a decline in patients with prostate cancer (from 11.7% to 6.6%; p <0.001) or carcinoma of unknown origin (from 3.5% to 0.7%; p <0.001). At 30-day follow-up, a reduction was observed in the proportion of patients experiencing symptomatic VTE recurrences (from 3.1% to 1.1%; p <0.001), major bleeding (from 3.1% to 2.2%; p=0.004), and death (from 11.9% to 8.4%; p <0.001). Multivariable analyses revealed a decreased risk over time for VTE recurrence (adjusted subdistribution hazard ratio [asHR]: 0.94 per year; 95%CI: 0.92-0.98), major bleeding (asHR: 0.98; 95%CI: 0.96-0.99), and death (aHR: 0.97; 95%CI: 0.96-0.98)

Conclusions: In this multicenter study of cancer patients with VTE, there was a decline in thrombotic, hemorrhagic, and fatal events from 2001 to 2020.

JACC CardioOncology Editor-in-Chief and CME Editor
Bonnie Ky, MD, MSCE, FACC

Author
Ahmad M. Slim, MD, FACC, FASNC, FSCCT

 
Important Dates

Date of Release: December 19, 2023
Term of Approval/Date of CME/MOC Expiration: December 18, 2024