Background: Despite advances in cancer and venous thromboembolism (VTE) management, the epidemiology of cancer-associated thrombosis management over time remains unclear.

Objectives: We analyzed data from the RIETE (Registro Informatizado de la Enfermedad Trombo Embólica) registry spanning 2001 to 2020 to investigate temporal trends in clinical characteristics and treatments for cancer-associated thrombosis.

Methods: Using multivariable survival regression, we examined temporal trends in risk-adjusted rates of symptomatic VTE recurrences, major bleeding, and death within 30 days after incident VTE.

Results: Among the 17,271 patients with cancer-associated thrombosis, there was a progressive increase in patients presenting with pulmonary embolism (from 44% in 2001-2005 to 55% in 2016-2020; 0.001 for trend), lung (from 12.7% to 18.1%; 0.001) or pancreatic cancer (from 3.8% to 5.6%; 0.003), and utilization of immunotherapy (from 0% to 7.4%; 0.001). Conversely, there was a decline in patients with prostate cancer (from 11.7% to 6.6%;  0.001) or carcinoma of unknown origin (from 3.5% to 0.7%; 0.001). At the 30-day follow-up, a reduction was observed in the proportion of patients experiencing symptomatic VTE recurrences (from 3.1% to 1.1%; 0.001), major bleeding (from 3.1% to 2.2%; 0.004), and death (from 11.9% to 8.4%; 0.001). Multivariable analyses revealed a decreased risk over time for VTE recurrence (adjusted subdistribution HR [asHR]: 0.94 per year; 95% CI: 0.92-0.98), major bleeding (asHR: 0.98; 95% CI: 0.96-0.99), and death (aHR: 0.97; 95% CI: 0.96-0.98).

Conclusions: In this multicenter study of cancer patients with VTE, there was a decline in thrombotic, hemorrhagic, and fatal events from 2001 to 2020. (Registro Informatizado de la Enfermedad Trombo Embólica [RIETE]; NCT02832245).

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774792PMC
http://dx.doi.org/10.1016/j.jaccao.2023.09.003DOI Listing

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