Abstract Number: PB0933
Meeting: ISTH 2022 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Ovarian cancer is among the most prothrombotic tumor diagnoses, and the majority of venous thromboembolism (VTE) occur within 60 days of surgery. Tissue factor bearing extracellular vesicles (TF-EV) are prothrombotic and have been linked to thrombosis in cancer and hypercoagulability of surgery. Rosuvastatin has been shown to reduce the generation of EV and decrease VTE risk in non-cancer populations. Whether rosuvastatin reduces TF-EV and prevents VTE following ovarian cancer surgery is unknown.
Aims: To evaluate effect of combining rosuvastatin with enoxaparin on circulating TF-EV following ovarian cancer surgery.
Methods: In a pilot trial for women undergoing ovarian cancer, women were randomized to enoxaparin 40 mg daily for 30 days or enoxaparin 40 mg for 30 days with rosuvastatin 40 mg daily from days 15 to 60. Women who did not want randomization received enoxaparin 40 mg for 30 days per standard of care. Total EV and TF-EV were assessed by flow cytometry. Bilateral lower extremity ultrasound was performed on day 30 and 60.
Results: Sixteen women received enoxaparin alone and seven women were randomized to enoxaparin with rosuvastatin. Circulating TF-EV were markedly elevated after surgery and decreased with time (Figure 1). There was no difference in number of circulating TF-EV with enoxaparin versus enoxaparin with rosuvastatin on day 30 (7.7±10.9 x103 TF-EV /uL versus 5.7±5.1 x103 TF-EV /uL, p=0.65) or day 60 (5.6±6.2 TF-EV/uL vs. 3.8±3.6×103 TF-EV/uL, p=0.53 respectively). Similarly, there were no differences in CRP or D-dimer between groups. No one experienced lower extremity deep vein thrombosis although portal vein thrombosis was diagnosed in enoxaparin arm. No major hemorrhages were observed.
Conclusion(s): The addition of rosuvastatin to enoxaparin following ovarian cancer surgery does not appear to impact number of circulating EV-TF nor alter markers of coagulation. Asymptomatic DVT was not observed in this cohort following ovarian cancer surgery.
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To cite this abstract in AMA style:
Osataphan A, Patell R, Rosovsky R, Elavalakanar P, Bregar A, Ramos A, Garrett L, Ren S, Neuberg D, Shea M, Zwicker J. A randomized clinical trial to evaluate the effect of rosuvastatin with enoxaparin on circulating tissue factor extracellular vesicles following ovarian cancer surgery [abstract]. https://abstracts.isth.org/abstract/a-randomized-clinical-trial-to-evaluate-the-effect-of-rosuvastatin-with-enoxaparin-on-circulating-tissue-factor-extracellular-vesicles-following-ovarian-cancer-surgery/. Accessed September 21, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/a-randomized-clinical-trial-to-evaluate-the-effect-of-rosuvastatin-with-enoxaparin-on-circulating-tissue-factor-extracellular-vesicles-following-ovarian-cancer-surgery/