Abstract Number: PB1115
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Cancer is a well-known risk factor for VTE. Data is presented on various metrics, for patients with VTE in the context of underlying Cancers and treatment.
Aims: To identify all VTE events diagnosed between 2015 and 2020, associated with active cancer as a risk factor. Assess treatment management over the study period looking at anticoagulation use and any changes to this over the study period.
Methods: All VTE events identified from targeted radiological data, comprising CT pulmonary angiograms. SPECT-CT and Doppler ultrasounds of upper and lower limbs, were reviewed for evidence of active cancer as a risk factor. Cancer type and degree of metastasis was also assessed, together with anticoagulant used.
Results:
| YEAR | Total VTE | Number Cancer RF | DVT (Met) | PE (Met) | Total |
| 2015 | 831 | 193 | 53 (7) | 140 (18) | 193 |
| 2016 | 861 | 188 | 75 (17) | 113 (18) | 188 |
| 2017 | 833 | 209 | 75 (18) | 134 (24) | 209 |
| 2018 | 822 | 179 | 67 (15) | 112 (28) | 179 |
| 2019 | 769 | 167 | 60 (10) | 107 (19) | 167 |
| 2020 | 765 | 166 | 66 (18) | 100 (22) | 166 |
| Total | 4881 | 1102 | 396 (36%) | 706 (64%) | 1102 |
Cancer Associated VTE events 2015 – 2020
A total of 4881 VTE events occurred over six years. 1102 (23%) of these had active cancer as a risk factor. Of the 3800 community-acquired (CAT) events, 721 (19%) were cancer-associated, compared to 381 of the 1081 hospital acquired (HAT) events (35%).There is a significant association of PE over DVT for cancer associated thrombosis. Overall 214/1102 (19%) demonstrated metastatic cancer. The most prevalent cancers were lung, prostate, breast and bowel, comprising 54% of all cancers associated with VTE. Low molecular weight heparin (LMWH) was most widely prescribed anticoagulation in 66% of cases, then Rivaroxaban at 23% and Apixaban at 6%. The use of direct oral anticoagulants generally, has increased significantly over the last two years.
Conclusions: Cancer is a major risk factor for VTE. Using the UK Department of Health, VTE risk assessment tool, only age (>60 years) demonstrated a larger risk within our VTE outcome data. The most common cancers identified are not those known to have the highest VTE risk, but are the more prevalent cancers, therefore explaining this outcome. With trials now published around this topic further use of direct oral anticoagulants would be expected to be seen.
To cite this abstract in AMA style:
Rowswell H, Nokes T. Treatment of Venous Thromboembolism (VTE) Events with Cancer as a Risk Factor in a Teaching Hospital: 2015 – 2020 [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/treatment-of-venous-thromboembolism-vte-events-with-cancer-as-a-risk-factor-in-a-teaching-hospital-2015-2020/. Accessed December 11, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/treatment-of-venous-thromboembolism-vte-events-with-cancer-as-a-risk-factor-in-a-teaching-hospital-2015-2020/