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D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis

2018; Springer Nature; Volume: 119; Issue: 8 Linguagem: Inglês

10.1038/s41416-018-0269-5

1532-1827

Luis Jara‐Palomares, Aurora Solier-López, Teresa Elías-Hernández, María Isabel Asensio-Cruz, Isabel Blasco-Esquivias, Verónica Sánchez‐López, María Rodríguez de la Borbolla, Elena Arellano‐Orden, Lionel Suárez-Valdivia, Samira Marín-Romero, Lucía Marín-Barrera, Aránzazu Ruiz-García, Emilio Montero-Romero, Silvia Navarro‐Herrero, José Luís López-Campos, María Pilar Serrano-Gotarredona, Juan Manuel Praena‐Fernández, José María Sánchez-Díaz, Remedios Otero,

Atrial Fibrillation Management and Outcomes

Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. Prospective, multicentre study to evaluate CAT with ≥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 and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3–15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19–52) and 5.81 for DD (95% CI: 1.1–31.7). This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.