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Biomarkers of Venous Thromboembolism Recurrence After Discontinuation of Anticoagulation for Cancer-Associated Thrombosis (HISPALIS- Study)

1Medical Research Institute Hospital La Fe, Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Valencia, Spain, 2Institute of Biomedicine of Seville (IBIS)/CSIC/University of Sevilla, Sevilla, Spain, 3Virgen del Rocio University Hospital, Medical Surgical Unit of Respiratory diseases, Sevilla, Spain, 4Virgen Macarena Hospital, Internal Medicine, Emergency Service, Sevilla, Spain, 5Medical Oncology, Virgen de Valme Hospital, Sevilla, Spain, 6Virgen del Rocio University Hospital, Department of Hematology, Sevilla, Spain

Abstract Number: PB2131

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis

Background: Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP) and P-selectine (PS) after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT.

Aims: To identify biomarkers of venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.

Methods: Prospective multicenter study to evaluate CAT with more than 3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD, PS and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence.

Results: Between 2013 and 2015, 325 patients were evaluated and 166 patients were ultimately enrolled in the study. The mean age was 62 ± 13.5 years and nearly 40% had metastasis. Incidence of VTE recurrence at 6 months was 9.6%, 95% confidence interval [CI]: 6-15%). Male sex, ratio DD basal/DD 21 days >2, hs-CRP and PS levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 4.32 for male sex (95% CI 1.10-16.96), 7.53 for ratio DD >2 (95% CI 1.97-28.71), 5.15 for hs-CRP (95% CI: 1.37-19.34) and 5.60 for PS
(95% CI: 1.48-21.08).

Conclusions: This study identified that ratio DD >2, hs-CRP and PS as potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify the optimal time to stop the anticoagulation in CAT patients. Funding sources: Instituto de Salud Carlos III (PI15/01085) and SETH.

To cite this abstract in AMA style:

Oto J, Sánchez-López V, Arellano-Orden E, Solier-López A, Marín-Romero S, Jara-Palomares L, Elias-Hernández T, Asencio-Cruz MI, Blasco-Esquivias I, Rodriguez-de-la-Borbolla M, Sánchez-Díaz JM, Rodriguez-Martorell FJ, Medina-Badenes P, Otero-Candelera R. Biomarkers of Venous Thromboembolism Recurrence After Discontinuation of Anticoagulation for Cancer-Associated Thrombosis (HISPALIS- Study) [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/biomarkers-of-venous-thromboembolism-recurrence-after-discontinuation-of-anticoagulation-for-cancer-associated-thrombosis-hispalis-study/. Accessed September 24, 2023.

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