کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6000761 | 1182937 | 2015 | 6 صفحه PDF | دانلود رایگان |

- 627 patients with acute PE, with/without malignancy, were followed for 1Â year at least.
- The malignant group had less embolic burden compared with the non-malignancy group.
- In malignancy patients, the survival time was longer in LMWH group than VKA group.
- The mortality in the first 6Â months was lower in LMWH group than VKA group.
BackgroundAs a special group in pulmonary embolism (PE), the baseline characteristics, better therapeutic strategy and prognosis of patients with concurrent malignancy need to be investigated. Long-term low-molecular-weight heparin (LMWH) is recommended for these patients, however, whether therapeutic strategy affects long-term prognosis remains unclear.MethodsIn this prospective study, acute symptomatic PE patients confirmed by imaging examinations, with/without malignancy, were enrolled and followed. Qanadli score was used to assess the embolic burden. The clinical endpoints included symptomatic recurrent venous thromboembolism (VTE), all-cause death and clinic relevant bleeding.ResultsIn the 627 patients enrolled, 92 patients had malignancy at baseline. The median follow-up period was 36Â months. The Qanadli score at baseline was lower in malignancy group than non-malignancy group (PÂ =Â 0.003). 48.9% of patients with malignancy died, while 11.4% of non-malignancy group died (P <Â 0.001). Malignancy was a risk factor of death (HR 5.659, 95%CI 3.090-10.366, P <Â 0.001). In malignancy group, 56 patients used long-term LMWH and 36 patients received oral vitamin K antagonist (VKA). The median survival time was 30Â months in LMWH group, significantly longer than 12.5Â months in VKA group (PÂ =Â 0.041). The mortality in the first 6Â months was lower in LMWH group than VKA group (19.6% vs. 41.7%, PÂ =Â 0.022).ConclusionsPE patients with malignancy had much higher incidence of all-cause death in spite of less embolic burden compared with patients without malignancy. Anticoagulation using long-term LMWH could prolong the survival time of PE patients with malignancy, and it was more effective than VKA.
Journal: Thrombosis Research - Volume 135, Issue 4, April 2015, Pages 582-587