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D-Dimer and Prothrombin Fragment 1 + 2 Predict Venous Thromboembolism in Patients With Cancer: Results From the Vienna Cancer and Thrombosis Study
Abstract
Purpose: Venous thromboembolism (VTE) is a well-recognized complication of cancer. Laboratory parameters might be useful to assess the VTE risk in patients with cancer. The aim of this study was to investigate D-dimer and prothrombin fragment 1 + 2 (F 1 + 2), which reflect activation of blood coagulation and fibrinolysis, for prediction of cancer-associated VTE. Patients and Methods: In a prospective, observational, cohort study of 821 patients with newly diagnosed cancer or progression of disease who did not recently receive chemotherapy, radiotherapy, or surgery were enrolled and followed for a median of 501 days (interquartile range, 255 to 731 days). The malignancies in these patients were as follows: breast (n = 132), lung (n = 119), stomach (n = 35), lower gastrointestinal tract (n = 106), pancreas (n = 46), kidney (n = 22), and prostate (n = 101) cancers; high-grade glioma (n = 102); malignant lymphoma (n = 94); multiple myeloma (n = 17); and other tumor types (n = 47). The study end point was occurrence of objectively confirmed symptomatic or fatal VTE. Results: VTE occurred in 62 patients (7.6%). The cutoff level for elevated D-dimer and elevated F 1 + 2 was set at the 75th percentile of the total study population. In multivariable analysis that included elevated D-dimer, elevated F 1 + 2, age, sex, surgery, chemotherapy, and radiotherapy, the hazard ratios (HRs) of VTE in patients with elevated D-dimer (HR, 1.8; 95% CI, 1.0 to 3.2; P = .048) and elevated F 1 + 2 (HR, 2.0; 95% CI, 1.2 to 3.6; P = .015) were statistically significantly increased. The cumulative probability of developing VTE after 6 months was highest in patients with both elevated D-dimer and elevated F 1 + 2 (15.2%) compared with patients with nonelevated D-dimer and nonelevated F 1 + 2 (5.0%; P < .001). Conclusion: High D-dimer and F 1 + 2 levels independently predict occurrence of VTE in patients with cancer.
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d -Dimer Testing to Determine the Duration of Anticoagulation Therapy
Palareti, G., Cosmi, B., Legnani, C., Tosetto, A., Brusi, C., Iorio, A., Pengo, V., Ghirarduzzi, A., Pattacini, C., Testa, S., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa054444 · Cited by 622
Cited by
Prediction of venous thromboembolism in cancer patients
Ay, C., Dunkler, D., Marosi, C., Chiriac, A.-L., Vormittag, R., Simanek, R., Quehenberger, P., Zielinski, C., & Pabinger, I. (2010) · Blood · doi:10.1182/blood-2010-02-270116 · Cited by 772
Self-citationTHALER, J., AY, C., MACKMAN, N., BERTINA, R. M., KAIDER, A., MAROSI, C., KEY, N. S., BARCEL, D. A., SCHEITHAUER, W., KORNEK, G., et al. (2012) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2012.04754.x · Cited by 274
Self-citationBiomarkers for prediction of venous thromboembolism in cancer
Pabinger, I., Thaler, J., & Ay, C. (2013) · Blood · doi:10.1182/blood-2013-04-460147 · Cited by 256
Self-citationYoung, A., Chapman, O., Connor, C., Poole, C., Rose, P., & Kakkar, A. K. (2012) · Nature Reviews Clinical Oncology · doi:10.1038/nrclinonc.2012.106 · Cited by 150
Metadata
- Authors
- Ay, C., Vormittag, R., Dunkler, D., Simanek, R., Chiriac, A.-L., Drach, J., Quehenberger, P., Wagner, O., Zielinski, C., & Pabinger, I.
- Venue
- Journal of Clinical Oncology
- Published
- 2009-09-01
- Volume
- 27
- Issue
- 25
- Pages
- 4124-4129
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2013996375
- Cited by
- 422
- References
- 1
- FWCI
- 16.35
- Type
- journal article
- Language
- en
- Open access
- closed
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- Ay, C., Vormittag, R., Dunkler, D., Simanek, R., Chiriac, A.-L., Drach, J., Quehenberger, P., Wagner, O., Zielinski, C., & Pabinger, I. (2009). D-Dimer and Prothrombin Fragment 1 + 2 Predict Venous Thromboembolism in Patients With Cancer: Results From the Vienna Cancer and Thrombosis Study. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2008.21.7752
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