Background: Venous thromboembolism (VTE) is a frequent complication of cancer. Elevated D-dimer is associated with an increased risk of cancer-associated VTE. Whether changes in D-dimer over time harbor additional prognostic information that may be exploited clinically for dynamic prediction of VTE is unclear.
Objectives: To explore the potential role of longitudinal D-dimer trajectories for personalized prediction of cancer-associated VTE.
Patients/methods: A total of 167 patients with active malignancy were prospectively enrolled (gastrointestinal: n = 59 [35%], lung: n = 56 [34%], brain: n = 50 [30%], others: n = 2 [1%]; metastatic disease: n = 74 [44%]). D-dimer (median = 0.8 µg/mL [25th-75th percentile: 0.4-2.0]) was measured at baseline and during 602 monthly follow-up visits. Joint models of longitudinal and time-to-event data were implemented to quantify the association between D-dimer trajectories and prospective risk of VTE.
Results: VTE occurred in 20 patients (250-day VTE risk = 12.1%, 95% confidence interval [CI], 7.8-18.5). D-dimer increased by 34%/month (0.47 µg/mL/month, 95% CI, 0.22-0.72, P < .0001) in patients who developed VTE, but remained constant in patients who did not develop VTE (change/month = -0.06 µg/mL, 95% CI, -0.15 to 0.02, P = .121). In joint modeling, a doubling of the D-dimer trajectory was associated with a 2.8-fold increase in the risk of VTE (hazard ratio = 2.78, 95% CI, 1.69-4.58, P < .0001). This finding was independent of established VTE risk factors. Highly personalized, dynamic predictions of VTE conditional on individual patients' D-dimer trajectories could be obtained.
Conclusions: D-dimer increases before the onset of cancer-associated VTE, but remains constant over time in patients without VTE. This study represents proof-of-concept that longitudinal trajectories of D-Dimer may advance the personalized assessment of VTE risk in the oncologic setting.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317804 | PMC |
| http://dx.doi.org/10.1111/jth.14774 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Embolic popliteal venous aneurysm revealing a congenital venous anatomical variation: A case report and literature review.
Radiol Case Rep
February 2025
Mohammed V University, Rabat, Morocco.
Venous aneurysms of the lower limbs are rare, and those located in the popliteal area are the most described. Congenital anatomical variations have been reported but are also exceptional. They can affect both superficial and deep veins.
View Article and Find Full Text PDFClearing Disseminated Venous Thromboembolism in a Single Procedure Using Thrombolytic-Free Large Bore Suction Thrombectomy: A Versatile Toolbox to Unclog the Venous Circulation.
Ann Vasc Dis
December 2024
Digestive & Liver Surgery, Singapore.
Disseminated venous thromboembolism (VTE) occurs commonly in cancer patients, who tend to have contraindications to systemic thrombolysis and require cancer surgery. Such clinical scenarios are often challenging to manage. In this case report, we illustrate an innovative, single procedural approach in such a patient to remove extensive VTE, improve symptoms, prevent hemodynamic decompensation, and allow for a minimal level of anticoagulation such that necessary cancer surgery can proceed safely.
View Article and Find Full Text PDFProstatectomy outcomes for patients with benign prostatic hyperplasia and its associated factors in East and West Gojjam zones comprehensive specialized hospitals, Northwest Ethiopia.
Eur J Med Res
December 2024
Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, P. O. Box 269, Debre Markos, Gojjam, Ethiopia.
Background: Benign prostatic hyperplasia (BPH) is non-cancerous growth of the prostate gland which surrounds the urethra. For men with BPH who are older than 50, a prostatectomy is a common surgical procedure. Open prostatectomy is still more prevalent in regions with limited access to advanced surgical procedures like transurethral resection of the prostate and robotic-assisted laparoscopic prostatectomy.
View Article and Find Full Text PDFAssociation of Social Isolation and Plasma Metabolites With the Risk of Venous Thromboembolism.
Arterioscler Thromb Vasc Biol
December 2024
Division of Nephrology and State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China. Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
Background: To explore the association of social isolation with venous thromboembolism (VTE) risk and the mediating role of metabolomics on this association.
Methods: Overall, 236 026 participants free of VTE and with complete metabolomics data at baseline from the UK Biobank were included. Social isolation was constructed based on the frequency of friend/family visits, weekly group activities, and living alone.
Lessons learned from setting up a hospital-based national registry for venous thromboembolic disorders in India.
J Family Med Prim Care
November 2024
Non-Communicable Diseases, Division, Indian Council of Medical Research, New Delhi, India.
Introduction: Health registries are instrumental in tracking trends in the number of people with diseases, monitoring treatment options, and assessing health outcomes. This research examines the challenges of establishing and maintaining a venous thromboembolism (VTE) registry in the Indian context.
Methods: A mixed-method approach with purposive sampling was conducted to capture the challenges faced by individuals playing key roles in the establishment and operation of the national registry on VTE.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!