Arterial thromboembolic events preceding the diagnosis of cancer in older persons
Open accessAbstract
Cancer patients face an increased risk of arterial thromboembolism; however, it is uncertain when this excess risk begins. This study evaluated the risk of arterial thromboembolism before cancer diagnosis. Using the population-based Surveillance Epidemiology and End Results-Medicare linked dataset, we identified 374 331 patients ≥67 years of age with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, uterine, pancreatic, gastric cancer, or non-Hodgkin lymphoma from 2005 through 2013. Cancer patients were individually matched by demographics and comorbidities to Medicare beneficiaries without cancer, who served as controls. Validated diagnosis codes were used to identify arterial thromboembolic events, defined as a composite of myocardial infarction or ischemic stroke. The Mantel-Haenszel estimator was used to compare risks of arterial thromboembolic events between cancer and noncancer groups during 30-day periods in the 360 days before date of cancer diagnosis. From 360 to 151 days before cancer diagnosis, the 30-day interval risks of arterial thromboembolic events were similar between cancer patients and matched controls. From 150 to 1 day before cancer diagnosis, the interval 30-day risks of arterial thromboembolic events were higher in cancer patients vs matched controls, progressively increasing as the cancer diagnosis date approached and peaking during the 30 days immediately before cancer diagnosis, when 2313 (0.62%) cancer patients were diagnosed with an arterial thromboembolic event vs 413 (0.11%) controls (odds ratio, 5.63; 95% confidence interval, 5.07-6.25). In conclusion, the risk of arterial thromboembolic events begins to increase 150 days before the date of cancer diagnosis in older persons and peaks in the 30 days before.
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As tumors grow, the coagulation system is activated, which is responsible for poor accumulation of drugs due to avascular areas and embolization of tumor tissues.
“As tumors grow, the coagulation system is also activated, which is responsible for the poor accumulation of drugs due to avascular areas and embolization of tumor tissues [32].”
From Approaches to Improve EPR-Based Drug Delivery for Cancer Therapy and Diagnosis (2023) · cites this paper as [32]
The Introduction says cancer-derived factors can trigger the coagulation cascade and links these effects to tumor burden. The Discussion suggests that cancer’s effects on coagulation may increase thromboembolism risk. Neither section supports the claims about poor drug accumulation in avascular areas or embolization of tumor tissues. (LLM, conf=0.89)
Experimental — accuracy not yet measuredFibrinolytic therapy helps dissolve fibrins in occluded vessels and improve tumor vasculature.
“Fibrinolytic therapy helps in dissolving fibrins in occluded vessels and improving the tumor vasculature [32,33,34,35,36].”
From Approaches to Improve EPR-Based Drug Delivery for Cancer Therapy and Diagnosis (2023) · cites this paper as [32]
The Introduction discusses cancer’s effects on coagulation and fibrinolytic pathways, while the Measurements section defines arterial thromboembolic events. Neither addresses fibrinolytic therapy dissolving fibrin in occluded vessels or improving tumor vasculature; searches for those treatment effects found no supporting passage in our copy. The cited passages have no page numbers. (LLM, conf=0.76)
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Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742 · see citing works
Edge, S. B., & Compton, C. C. (2010) · Annals of Surgical Oncology · doi:10.1245/s10434-010-0985-4 · Cited by 9,055 · see citing works
Heart disease and stroke statistics-2018 update: a report from the american heart association
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., Chiuve, S. E., Cushman, M., Delling, F. N., Deo, R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000558 · Cited by 7,146 · see citing works
Report of the Committee on Hodgkin's Disease Staging Classification.
Carbone, P. P., Kaplan, H. S., Musshoff, K., Smithers, D. W., & Tubiana, M. (1971) · PubMed · Cited by 4,166 · see citing works
Development and validation of a predictive model for chemotherapy-associated thrombosis
Khorana, A. A., Kuderer, N. M., Culakova, E., Lyman, G. H., & Francis, C. W. (2008) · Blood · doi:10.1182/blood-2007-10-116327 · Cited by 2,222 · see citing works
Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction
Yeh, R. W., Sidney, S., Chandra, M., Sorel, M. E., Selby, J. V., & Go, A. S. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0908610 · Cited by 1,732 · see citing works
Age at stroke: Temporal trends in stroke incidence in a large, biracial population
Kissela, B. M., Khoury, J. C., Alwell, K., Moomaw, C. J., Woo, D., Adeoye, O., Flaherty, M. L., Khatri, P., Ferioli, S., De Los Rios La Rosa, F., et al. (2012) · Neurology · doi:10.1212/wnl.0b013e318270401d · Cited by 743 · see citing works
Validating Administrative Data in Stroke Research
Tirschwell, D., & Longstreth, W. T. (2002) · Stroke · doi:10.1161/01.str.0000032240.28636.bd · Cited by 664 · see citing works
Risk of Arterial Thromboembolism in Patients With Cancer
Navi, B. B., Reiner, A. S., Kamel, H., Iadecola, C., Okin, P. M., Elkind, M. S. V., Panageas, K. S., & DeAngelis, L. M. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.06.047 · Cited by 658 · see citing works
Self-citationCoagulation and cancer: biological and clinical aspects
Falanga, A., Marchetti, M., & Vignoli, A. (2012) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.12075 · Cited by 555 · see citing works
Kiyota, Y., Schneeweiß, S., Glynn, R. J., Cannuscio, C. C., Avorn, J., & Solomon, D. H. (2004) · American Heart Journal · doi:10.1016/j.ahj.2004.02.013 · Cited by 533 · see citing works
Carrier, M., Gal, G. L., Wells, P. S., et al. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-149-5-200809020-00007 · Cited by 303 · see citing works
Screening for Occult Cancer in Unprovoked Venous Thromboembolism
Carrier, M., Lazo‐Langner, A., Shivakumar, S., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1506623 · Cited by 300 · see citing works
NETosis: A New Factor in Tumor Progression and Cancer-Associated Thrombosis
Demers, M., & Wagner, D. D. (2014) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0034-1370765 · Cited by 261 · see citing works
Association between incident cancer and subsequent stroke
Navi, B. B., Reiner, A. S., Kamel, H., Iadecola, C., Elkind, M. S. V., Panageas, K. S., & DeAngelis, L. M. (2014) · Annals of Neurology · doi:10.1002/ana.24325 · Cited by 258 · see citing works
Self-citationGuidance for the prevention and treatment of cancer-associated venous thromboembolism
Khorana, A. A., Carrier, M., Garcia, D. A., & Lee, A. Y. Y. (2016) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-015-1313-4 · Cited by 210 · see citing works
Zöller, B., Ji, J., Sundquist, J., & Sundquist, K. (2012) · European Journal of Cancer · doi:10.1016/j.ejca.2012.01.005 · Cited by 199 · see citing works
Risk of coronary heart disease in patients with cancer: A nationwide follow-up study from Sweden
Zöller, B., Ji, J., Sundquist, J., & Sundquist, K. (2011) · European Journal of Cancer · doi:10.1016/j.ejca.2011.09.015 · Cited by 159 · see citing works
First-Ever Stroke as Initial Presentation of Systemic Cancer
Taccone, F. S., Jeangette, S., & Blecic, S. A. (2008) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2008.01.007 · Cited by 129 · see citing works
Myocardial infarction and future risk of cancer in the general population—the Tromsø Study
Rinde, L. B., Småbrekke, B., Hald, E. M., Brodin, E. E., Njølstad, I., Mathiesen, E. B., Løchen, M., Wilsgaard, T., Brækkan, S. K., Vik, A., et al. (2017) · European Journal of Epidemiology · doi:10.1007/s10654-017-0231-5 · Cited by 85 · see citing works
Bang, O. Y., Chung, J., Lee, M. J., Kim, S. J., Cho, Y. H., Kim, G., Chung, C., Lee, K. H., Ahn, M., & Moon, G. J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0159170 · Cited by 70 · see citing works
Incident Cancer in a Cohort of 3,247 Cancer Diagnosis Free Ischemic Stroke Patients
Qureshi, A. I., Malik, A., Saeed, O., et al. (2015) · Cerebrovascular Diseases · doi:10.1159/000375154 · Cited by 62 · see citing works
Korabathina, R., WEINTRAUB, A. R., Price, L. L., et al. (2013) · Circulation · doi:10.1161/circulationaha.113.003543 · Cited by 56 · see citing works
Risk and Prognosis of Cancer After Lower Limb Arterial Thrombosis
Sundbøll, J., Veres, K., Horváth–Puhó, E., Adelborg, K., & Sørensen, H. T. (2018) · Circulation · doi:10.1161/circulationaha.117.032617 · Cited by 44 · see citing works
Multifocal strokes as the presentation of occult lung cancer
Navi, B. B., DeAngelis, L. M., & Segal, A. Z. (2007) · Journal of Neuro-Oncology · doi:10.1007/s11060-007-9419-y · Cited by 31 · see citing works
Self-citationPopulation‐based assessment of determining predictors for quality of prostate cancer surveillance
Chamie, K., Williams, S. B., Hershman, D. L., Wright, J. D., Nguyen, P. L., & Hu, J. C. (2015) · Cancer · doi:10.1002/cncr.29574 · Cited by 24 · see citing works
Yeh, E. T. H., & Chang, H. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.07.719 · Cited by 23 · see citing works
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Fang, J., Islam, W., & Maeda, H. (2020) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2020.06.005 · Cited by 757 · see citing works
Strategies to improve the EPR effect: A mechanistic perspective and clinical translation
Ikeda-Imafuku, M., Wang, L. L.-W., Rodrigues, D., Shaha, S., Zhao, Z., & Mitragotri, S. (2022) · Journal of Controlled Release · doi:10.1016/j.jconrel.2022.03.043 · Cited by 330 · see citing works
Maeda, H. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11030229 · Cited by 167 · see citing works
Approaches to Improve EPR-Based Drug Delivery for Cancer Therapy and Diagnosis
Subhan, M. A., Parveen, F., Filipczak, N., Yalamarty, S. S. K., & Torchilin, V. P. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13030389 · Cited by 98 · see citing works
“As tumors grow, the coagulation system is also activated, which is responsible for the poor accumulation of drugs due to avascular areas and embolization of tumor tissues [32].”
BackgroundIslam, W., Kimura, S., Islam, R., Harada, A., Ono, K., Fang, J., Niidome, T., Sawa, T., & Maeda, H. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11060487 · Cited by 30 · see citing works
- Authors
- Navi, B. B., Reiner, A. S., Kamel, H., Iadecola, C., Okin, P. M., Tagawa, S. T., Panageas, K. S., & DeAngelis, L. M.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Department of Neurology and
- Weill Cornell Medicine (US)
- Department of Medicine, Division of Cardiology, and
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2019-02-21
- Volume
- 133
- Issue
- 8
- Pages
- 781-789
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC6384185
- OpenAlex
- W2906175764
- Cited by
- 179
- References
- 27
- Citations by year
- 2026: 9 · 2025: 20 · 2024: 25 · 2023: 30 · 2022: 20 · 2021: 30 · 2020: 22 · 2019: 22
- FWCI
- 17.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (P30CA008748)
- National Institute of Neurological Disorders and Stroke (K23NS091395)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- arterial thromboembolism, cancer diagnosis, myocardial infarction, ischemic stroke, older adults, cancer-associated thrombosis, Medicare beneficiaries
- MeSH terms
- Aged, Brain Ischemia, Female, Medicare, Humans, Male, Middle Aged, Myocardial Infarction, Neoplasms, Registries, Thromboembolism, Time Factors, United States, Stroke
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