Periprocedural Interruption of Anticoagulation in Patients with Cancer-Associated VTE: An Analysis of Thrombotic and Bleeding Outcomes.
J Thromb Haemost. 2019 Apr 30;:
Authors: Shaw JR, Douketis J, Le Gal G, Carrier M
BACKGROUND: Patients with cancer are at high risk for venous thromboembolic events (VTE). VTE can lead to significant morbidity among patients with cancer and is estimated to be one of the leading causes of death among cancer patients. Patients with cancer often require invasive procedures for biopsy or therapeutic purposes. There is a lack of data on post-operative outcomes following interruption of anticoagulation in this population.
OBJECTIVE: Assess 30-day post-operative thromboembolic and major bleeding complication rates following the perioperative interruption of anticoagulation in patients with cancer-associated VTE.
METHODS: We conducted a retrospective self-controlled case series study with cancer-associated VTE undergoing perioperative interruption of anticoagulation at a dedicated tertiary care anticoagulation clinic for invasive procedures between January 2013 and March 2018. The primary efficacy and safety outcomes were the 30-day post-operative rates of VTE and major bleeding, respectively. The secondary outcomes included the 30-day rates of clinically relevant non-major bleeding (CRNMB) and overall mortality. Patient undergoing multiple perioperative anticoagulation interruptions were included.
RESULTS: 146 patients undergoing 171 periprocedural interruptions were included in our cohort. The 30-day rates of VTE and major bleeding were both 4.1% [95% CI 2.0-8.2]. The 30-day rate of CRNMB was 2.9% [95% CI 1.3-6.7] and the 30-day overall mortality rate was 0.6% [95% CI 0.1-3.4]. There were no fatal post-operative VTE or major bleeding events.
CONCLUSIONS: The periprocedural interruption of anticoagulation in patients with cancer-associated VTE is associated with high post-operative rates of VTE and major bleeding. Patients with cancer-associated VTE may warrant closer follow-up for VTE and bleeding complications after invasive procedures. This article is protected by copyright. All rights reserved.
PMID: 31038838 [PubMed - as supplied by publisher]