Abstract Number: PB2139
Meeting: ISTH 2020 Congress
Background: The role of coagulation factors to the development of cancer-associated thrombosis (CAT) has not been completely clarified.
Aims: To evaluate levels of coagulation factors in CAT compared to VTE not cancer-related.
Methods: Consecutive patients with a first VTE between 2010-2019 were enrolled. Procoagulant (II, VIII, IX, X, XI and fibrinogen), anticoagulant (antithrombin, protein C and protein S), and fibrinolysis factors (plasminogen and plasminogen activator inhibitor-1) were analysed at admission. Outcomes were the difference in coagulation profile between CAT and VTE patients, and the association between coagulation profile at admission and VTE recurrence or bleeding complications at follow-up.
Results: .659 patients with a first VTE were enrolled, 104 (16%) CAT and 555 (84%) VTE without cancer. We showed a significant increase in the mean levels of procoagulant factors in patients with CAT. Factor VIII was increased in CAT (200 ± 65%) compared to VTE (180 ± 60%, p = 0.002), as well as factor IX (142 ± 37% vs. 130 ± 43%, p = 0.009) and factor XI (127 ± 33% vs. 119 ± 32%, p = 0.042). No difference was found for anticoagulant and fibrinolysis factors. During follow-up, 38 (48.1%) CAT underwent recurrence vs. 137 (30.9%) non cancer-VTE (p = 0.003). Twelve (19.4%) CAT patients experienced bleeding complications vs. 36 (9.8%) VTE, p = 0.028. Cancer patients with factor VIII >192% at admission showed a significantly increased risk of VTE recurrence (OR 8.3 [95% CI 1.01-68.8] while FIX levels < 150% was protective (OR 0.62 [95% CI 0.4-0.92]). Factor levels were not associated with the occurrence of bleeding complications
Conclusions: Patients with CAT showed a hypercoagulable state mainly due to higher levels of procoagulant factors. Factors VIII and IX measured at CAT diagnosis may be an easy potential tool to early reveal patients at increased risk of VTE recurrence.
To cite this abstract in AMA style:Campello E, Spiezia L, Simion C, Rosin E, Bulato C, Radu C, Gavasso S, Simioni P. Plasma Levels of Procoagulant and Anticoagulant Factors in Patients with Acute Cancer-associated Thrombosis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/plasma-levels-of-procoagulant-and-anticoagulant-factors-in-patients-with-acute-cancer-associated-thrombosis/. Accessed October 1, 2023.
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