Acute pulmonary embolism and cancer: findings from the COPE study

被引：6

作者：

Becattini, Cecilia ^{[1
]}

Cimini, Ludovica Anna ^{[1
]}

Bassanelli, Giorgio ^{[2
]}

Maggioni, Aldo P. ^{[3
]}

Pomero, Fulvio ^{[4
]}

Lobascio, Ilaria ^{[5
]}

Enea, Iolanda ^{[6
]}

Pomata, Daniela P. ^{[7
]}

Ruggieri, Maria Pia ^{[8
]}

Zalunardo, Beniamino ^{[9
]}

Novelli, Anna ^{[10
]}

Di Fusco, Stefania Angela ^{[11
]}

Triggiani, Marco ^{[12
]}

Marzolo, Marco ^{[13
]}

Fioravanti, Chiara ^{[14
]}

Agnelli, Giancarlo ^{[1
]}

Gonzini, Lucio ^{[3
]}

Gulizia, Michele M. ^{[3
,15
]}

COPE Investigators

机构：

[1] Univ Perugia, Internal Vasc & Emergency Med, Stroke Unit, Piazzale Lucio Severi 1, I-06129 Perugia, Italy

[2] Osped Alessandro Manzoni, UO Radioterapia, Lecce, Italy

[3] Heart Care Fdn, ANMCO Res Ctr, Florence, Italy

[4] Osped Michele & Pietro Ferrero, Dept Internal Med, Verduno, Italy

[5] Osped Civile, Dept Cardiol, Arzignano, Italy

[6] AORN S Anna & S Sebastiano, UOC Med & Chirurg Urgenza, Caserta, Italy

[7] Osped Policlin S Orsola Malpighi, Med Urgenza & Pronto Soccorso, Bologna, Italy

[8] AO San Giovanni Addolorata, UOC Med Urgenza & Pronto Soccorso, Rome, Italy

[9] Azienda UlSS 2 Marca Trevigiana, Angiol Unit, Castelfranco Veneto, Treviso, Italy

[10] Ospedali Riuniti, Pronto Soccorso & Med Urgenza, Livorno, Italy

[11] PO San Filippo Neri, Cardiol Clin & Riabilitativa, Rome, Italy

[12] Osped Civile La Memoria, UO Cardiol, Gavardo, Brescia, Italy

[13] Osped S Maria Misericordia, UO C Med Interna Angiol, Rovigo, Italy

[14] Ospedali Galliera, Med Interna, Genoa, Italy

[15] Garibaldi Nesima Hosp, Div Cardiol, Catania, Italy

来源：

CLINICAL RESEARCH IN CARDIOLOGY | 2024年 / 113卷 / 02期

关键词：

Pulmonary embolism; Cancer-associated thromboembolism; Cancer; Anticoagulant; DOAC; VENOUS THROMBOEMBOLISM; ANTICOAGULANT TREATMENT;

D O I：

10.1007/s00392-023-02323-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Patients with acute venous thromboembolism associated with cancer have an increased risk of recurrences and bleeding in the long term. Research question To describe the clinical features and short-term course of patients with acute pulmonary embolism (PE) and active cancer, previous cancer or no cancer. Study design and methods Patients with acute PE included in COPE-prospective, multicentre study of adult patients with acute, symptomatic, objectively diagnosed PE-were classified as having active cancer, previous cancer, or no cancer. Results Overall, 832 patients had active cancer, 464 with previous cancer and 3660 patients had no cancer at the time of acute PE. The most prevalent primary sites of active cancer were urogenital (23.0%), gastrointestinal (21.0%), and lung (19.8%), with a high prevalence of metastatic disease (57.6%) and ongoing anticancer treatment (16.2%). At discharge, a direct oral anticoagulant was used in 43.1%, 78.8%, and 82.0% of patients with active cancer, previous cancer, and no cancer, respectively. Rates of death in-hospital and at 30 days were higher in patients with active cancer compared to patients with previous cancer and no cancer (7.9% vs. 4.3% vs. 2.2% and 13.8% vs. 5.2% vs. 2.6%, respectively). Rates of major bleeding were 4.8%, 2.6%, and 2.4%, respectively. Among patients with active cancer, lung or metastatic cancer were independent predictors of death; brain, hematological or gastrointestinal cancer had the highest risk of major bleeding. Interpretation Among patients with acute PE, those with active cancer have high risks for death or major bleeding within 30 days. These risks vary based on primary site of cancer. [GRAPHICS] .

引用

页码：288 / 300

页数：13

共 20 条

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