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Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice

Authors :
Yasushi Matsuzawa
Masami Kosuge
Kiyoshi Hibi
Hidefumi Nakahashi
Kazuo Kimura
Yugo Minamimoto
Ryosuke Sato
Yutaka Ogino
Noriaki Iwahashi
Toshiyuki Ishikawa
Tomoaki Ishigami
Toshiaki Ebina
Yuichiro Kimura
Kozo Okada
Kouichi Tamura
Source :
Journal of Clinical Medicine, Journal of Clinical Medicine; Volume 10; Issue 20; Pages: 4648, Journal of Clinical Medicine, Vol 10, Iss 4648, p 4648 (2021)
Publication Year :
2021

Abstract

Background: The efficacy and bleeding complications of direct oral anticoagulant (DOAC) therapy for isolated distal deep vein thrombosis (IDDVT) associated with cancer in routine clinical practice remain unclear. Moreover, prior studies on prolonged therapy for IDDVT are limited. Methods: This retrospective study enrolled 1641 consecutive patients with acute venous thromboembolism (VTE) who had received oral anticoagulant therapy, including warfarin or DOAC, between April 2014 and September 2018 in our institutions. In these patients, 200 patients with cancer-associated IDDVT were evaluated. Results: Mean follow-up period was 780 ± 593 days. Major bleeding and VTE recurrence were observed in 22 (11.0%) and 11 (5.5%) patients, respectively. In multivariate analysis, statistically significant factors correlated with major bleeding were advanced cancer stage, high performance status, stomach cancer, and gallbladder cancer; those correlated with all-cause death were advanced cancer stage, high performance status, liver dysfunction, pancreatic cancer, and major bleeding. Cumulative events of major bleeding and recurrence between patients with prolonged DOAC therapy (≥90 days) and those with nonprolonged therapy were not significantly different. Conclusions: Preventing major bleeding is important because it is a significant risk factor for all-cause death. Major bleeding and recurrent events were comparable between prolonged and nonprolonged therapy.

Details

ISSN :
20770383
Volume :
10
Issue :
20
Database :
OpenAIRE
Journal :
Journal of clinical medicine
Accession number :
edsair.doi.dedup.....f907cca1f141a21c54e648b04ccb3aa6