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  1. Article ; Online: Net Clinical Benefit of Oral Anticoagulation Among Frail Patients With Atrial Fibrillation: Nationwide Cohort Study.

    Søgaard, Mette / Jensen, Martin / Højen, Anette Arbjerg / Larsen, Torben Bjerregaard / Lip, Gregory Y H / Ording, Anne Gulbech / Nielsen, Peter Brønnum

    Stroke

    2024  Volume 55, Issue 2, Page(s) 413–422

    Abstract: Background: Frail people with atrial fibrillation are often undertreated with oral anticoagulants (OACs), and evidence for the net clinical benefit (NCB) of OAC is sparse. We, therefore, examined the risk of thromboembolic events, major bleeding, and ... ...

    Abstract Background: Frail people with atrial fibrillation are often undertreated with oral anticoagulants (OACs), and evidence for the net clinical benefit (NCB) of OAC is sparse. We, therefore, examined the risk of thromboembolic events, major bleeding, and NCB of anticoagulation treatment.
    Methods: This was a nationwide cohort study including frail patients aged with incident atrial fibrillation between 2013 and 2018. Patients were categorized according to OAC treatment exposure. One-year risks of thromboembolic events and major bleeding were ascertained where death was treated as a competing risk. The NCB of anticoagulation was assessed by a bivariate trade-off between thromboembolism and bleeding.
    Results: We identified 36 223 frail patients with atrial fibrillation (median age, 79 years; 50.5% female), of whom 61.8% started OAC therapy, while 38.2% were untreated despite indication for stroke prevention. At 1 year, the risk of thromboembolic events was 2.1% (95% CI, 1.8%-2.3%) among patients not receiving OAC versus 1.5% (95% CI, 1.4%-1.7%) in patients with OAC. The bleeding risk was 3.2% (95% CI, 2.9%-3.5%) among patients without OAC versus 3.5% (95% CI, 3.2%-3.8%) among anticoagulated patients. The NCB was 0.70% (95% CI, 0.32%-1.08%), suggesting a benefit of OAC treatment; however, the NCB declined with age and increasing frailty and was lowest among patients >75 years of age or with high frailty level.
    Conclusions: Frail patients with atrial fibrillation are often untreated with OAC in routine clinical care despite an indication for stroke prevention. The NCB balancing thromboembolic events and major bleeding was in favor of anticoagulation but decreased with advancing age and increasing frailty.
    MeSH term(s) Humans ; Female ; Aged ; Male ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Cohort Studies ; Frail Elderly ; Frailty/epidemiology ; Anticoagulants/adverse effects ; Thromboembolism/epidemiology ; Thromboembolism/etiology ; Thromboembolism/prevention & control ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Stroke/epidemiology ; Stroke/prevention & control
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.123.044407
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  2. Article ; Online: Effectiveness and safety of direct oral anticoagulation vs. warfarin in frail patients with atrial fibrillation.

    Søgaard, Mette / Ording, Anne Gulbech / Skjøth, Flemming / Larsen, Torben Bjerregaard / Nielsen, Peter Brønnum

    European heart journal. Cardiovascular pharmacotherapy

    2023  Volume 10, Issue 2, Page(s) 137–146

    Abstract: Aims: Although frail patients with atrial fibrillation (AF) carry a high risk of stroke and treatment-related bleeding complications, evidence for the safety and effectiveness of anticoagulation remains sparse. This study investigated the effectiveness ... ...

    Abstract Aims: Although frail patients with atrial fibrillation (AF) carry a high risk of stroke and treatment-related bleeding complications, evidence for the safety and effectiveness of anticoagulation remains sparse. This study investigated the effectiveness and safety of direct oral anticoagulant (DOAC) vs. warfarin in frail AF patients.
    Methods and results: Nationwide registry-based cohort study including 32 048 anticoagulation naïve frail patients (median age 80 years, 53% female) with incident AF during 2012-20. Frailty was assessed using the hospital frailty risk score. To address baseline confounding, we applied inverse probability of treatment weighting (IPTW) and marginal structural models with weighted pooled regression to compute weighted hazard ratios (wHRs) and risk differences for thromboembolism and major bleeding comparing specific DOAC doses with warfarin. After AF diagnosis, 6747 (21.1%) initiated warfarin, 17 076 (50.3%) initiated standard-dose DOAC, and 9179 (28.6%) initiated reduced-dose DOAC. Comparative effectiveness analyses in the IPTW pseudo-populations revealed similar thromboembolism risk between standard-dose DOAC and warfarin [wHR 0.95, 95% confidence interval (CI) 0.80-1.13] and between reduced-dose DOAC and warfarin (wHR 0.97, 95% CI 0.77-1.23). The 1-year thromboembolic event-free survival difference was -0.2% for DOAC, regardless of dosing, vs. warfarin. Major bleeding risk was significantly lower with standard-dose DOAC (wHR 0.69, 95% CI 0.59-0.87) and reduced-dose DOAC (wHR 0.67, 95% CI 0.55-0.81) vs. warfarin. The 1-year bleeding risk difference with DOAC ranged from -1.3% to -3.0%.
    Conclusion: Our findings indicate comparable thromboembolism risk and significantly lower bleeding risk with both standard and reduced DOAC regimens compared with warfarin in frail AF patients in routine care.
    MeSH term(s) Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Warfarin ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Anticoagulants ; Cohort Studies ; Frail Elderly ; Frailty/diagnosis ; Frailty/epidemiology ; Frailty/complications ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Thromboembolism/diagnosis ; Thromboembolism/epidemiology ; Thromboembolism/etiology
    Chemical Substances Warfarin (5Q7ZVV76EI) ; Anticoagulants
    Language English
    Publishing date 2023-12-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2808613-2
    ISSN 2055-6845 ; 2055-6837
    ISSN (online) 2055-6845
    ISSN 2055-6837
    DOI 10.1093/ehjcvp/pvad091
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  3. Article ; Online: Adverse Events and All-Cause Mortality in Danish Patients with Cerebral Venous Thrombosis: A Nationwide Cohort Study.

    Ording, Anne Gulbech / Skjøth, Flemming / Andersen, Søren Due / Larsen, Torben Bjerregaard

    Thrombosis and haemostasis

    2022  Volume 122, Issue 9, Page(s) 1524–1531

    Abstract: Background:  Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular ... ...

    Abstract Background:  Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular events.
    Methods:  A Danish cohort study with adult patients diagnosed with CVT (
    Results:  Major bleeding risks were 1.2% for CVT and 0.7% for VTE at 6 months; these risks increased to 2.7% and 2.6%, respectively, at 5 years. Although rare, intracranial bleeding risks were markedly higher for CVT (2.9%) than for VTE (0.4%) at 5 years (HR = 8.9, 95% CI: 5.3-15.1). Incidences of ischemic stroke were 5.9% for CVT and 0.3% for VTE, at 6 months; and 10.0% and 1.4%, respectively, at 5 years (HR = 9.5, 95% CI: 7.1-12.7). In contrast, incidence of cardiac events was lower for CVT that VTE (1.7% vs. 3.6% at 5 years). Mortality risk was higher after CVT compared with VTE, at 6 months (6.6% vs. 3.8%), but the risks differed little at 5 years (14.3% vs. 14.1%).
    Conclusion:  Intracranial bleeding, ischemic stroke, and mortality risks were higher for patients with CVT than matched patients with VTE and the general population, particularly within 6 months after diagnosis.
    MeSH term(s) Adult ; Cohort Studies ; Denmark ; Hemorrhage ; Humans ; Intracranial Thrombosis ; Ischemic Stroke ; Pulmonary Embolism ; Risk Factors ; Venous Thromboembolism ; Venous Thrombosis
    Language English
    Publishing date 2022-06-10
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/s-0042-1743473
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  4. Article ; Online: Associations between pregnancy-related factors and birth characteristics with risk of rare uterine cancer subtypes: a Nordic population-based case-control study.

    Abril, Jazmine / Trabert, Britton / Troisi, Rebecca / Grotmol, Tom / Ekbom, Anders / Engeland, Anders / Gissler, Mika / Glimelius, Ingrid / Madanat-Harjuoja, Laura / Gulbech Ording, Anne / Sørensen, Henrik Toft / Tretli, Steinar / Bjørge, Tone

    Cancer causes & control : CCC

    2023  Volume 35, Issue 5, Page(s) 741–747

    Abstract: Purpose: Uterine sarcomas are a rare group of uterine malignancies. Due to the low incidence and changes in uterine sarcoma classification, risk factors are not well characterized. Our objective was to evaluate risk factors for uterine sarcoma and ... ...

    Abstract Purpose: Uterine sarcomas are a rare group of uterine malignancies. Due to the low incidence and changes in uterine sarcoma classification, risk factors are not well characterized. Our objective was to evaluate risk factors for uterine sarcoma and compare risk factors between uterine sarcoma, malignant mixed Mullerian tumors (MMMTs), and type I endometrial carcinomas.
    Methods: This nested case-control study utilized linked data from population-based medical birth and cancer registries in Denmark, Finland, Norway, and Sweden. Up to 10 controls were matched on country and birth year for each uterine cancer case. Using multivariable adjusted multinomial logistic regression, estimates of the associations between pregnancy-related factors and risk of uterine sarcoma, MMMTs, and type I endometrial carcinomas were determined.
    Results: Having a very-low-birth-weight infant (< 1500 vs. 2500-3999 g: OR [95% CI] 2.83 [1.61-4.96]) was associated with an increased risk of uterine sarcoma. Whereas, having a more recent pregnancy was associated with reduced risks of MMMT (< 10 vs. ≥ 30 years: 0.66 [0.20-2.23]) and type 1 endometrial carcinomas (0.35 [0.30-0.41]) but not uterine sarcomas (1.33 [0.90-1.98], p-heterogeneity < 0.01).
    Conclusion: Our study provides evidence that risk factors for uterine sarcoma and MMMT, previously grouped with uterine sarcomas, vary substantially. Additionally, MMMT and type I endometrial carcinomas are more similar than uterine sarcoma in that pregnancy complications like gestational hypertension and preeclampsia were associated with reduced risks of both but not uterine sarcoma, suggesting different etiologies.
    MeSH term(s) Humans ; Female ; Case-Control Studies ; Pregnancy ; Uterine Neoplasms/epidemiology ; Risk Factors ; Adult ; Middle Aged ; Sarcoma/epidemiology ; Registries ; Scandinavian and Nordic Countries/epidemiology ; Sweden/epidemiology ; Aged ; Finland/epidemiology ; Norway/epidemiology ; Denmark/epidemiology
    Language English
    Publishing date 2023-12-22
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1064022-8
    ISSN 1573-7225 ; 0957-5243
    ISSN (online) 1573-7225
    ISSN 0957-5243
    DOI 10.1007/s10552-023-01832-6
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    Zs.A 3375: Show issues Location:
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  5. Article: Adverse Events and All-Cause Mortality in Danish Patients with Cerebral Venous Thrombosis: A Nationwide Cohort Study

    Ording, Anne Gulbech / Skjøth, Flemming / Andersen, Søren Due / Larsen, Torben Bjerregaard

    Thrombosis and Haemostasis

    2022  Volume 122, Issue 09, Page(s) 1524–1531

    Abstract: Background: Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular ... ...

    Abstract Background: Cerebral venous thrombosis (CVT) is a rare manifestation of stroke and venous thromboembolism (VTE), compared with deep vein thrombosis (DVT) and pulmonary embolism (PE). We examined whether CVT was associated with adverse cardiovascular events.
    Methods: A Danish cohort study with adult patients diagnosed with CVT ( N  = 1,015) between 1997 and 2017. We matched 10 patients with VTE (DVT and PE) to each patient with CVT for age, sex, and diagnosis year. We also matched 10 individuals from the general population to each patient with CVT. We computed cumulative incidence and estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) at 5 years for major bleeding, intracranial bleeding, ischemic stroke, and cardiovascular events. Death was examined separately.
    Results: Major bleeding risks were 1.2% for CVT and 0.7% for VTE at 6 months; these risks increased to 2.7% and 2.6%, respectively, at 5 years. Although rare, intracranial bleeding risks were markedly higher for CVT (2.9%) than for VTE (0.4%) at 5 years (HR = 8.9, 95% CI: 5.3–15.1). Incidences of ischemic stroke were 5.9% for CVT and 0.3% for VTE, at 6 months; and 10.0% and 1.4%, respectively, at 5 years (HR = 9.5, 95% CI: 7.1–12.7). In contrast, incidence of cardiac events was lower for CVT that VTE (1.7% vs. 3.6% at 5 years). Mortality risk was higher after CVT compared with VTE, at 6 months (6.6% vs. 3.8%), but the risks differed little at 5 years (14.3% vs. 14.1%).
    Conclusion: Intracranial bleeding, ischemic stroke, and mortality risks were higher for patients with CVT than matched patients with VTE and the general population, particularly within 6 months after diagnosis.
    Keywords sinuses ; cerebral venous thrombosis ; stroke ; hemorrhage ; cardiovascular events
    Language English
    Publishing date 2022-06-10
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/s-0042-1743473
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  6. Article: Long-Term Management of Pulmonary Embolism: A Review of Consequences, Treatment, and Rehabilitation.

    Højen, Anette Arbjerg / Nielsen, Peter Brønnum / Overvad, Thure Filskov / Albertsen, Ida Ehlers / Klok, Frederikus A / Rolving, Nanna / Søgaard, Mette / Ording, Anne Gulbech

    Journal of clinical medicine

    2022  Volume 11, Issue 19

    Abstract: The concept of pulmonary embolism is evolving. Recent and emerging evidence on the treatment of specific patient populations, its secondary prevention, long-term complications, and the unmet need for rehabilitation has the potential to change clinical ... ...

    Abstract The concept of pulmonary embolism is evolving. Recent and emerging evidence on the treatment of specific patient populations, its secondary prevention, long-term complications, and the unmet need for rehabilitation has the potential to change clinical practice for the benefit of the patients. This review discusses the recent evidence from clinical trials, observational studies, and guidelines focusing on anticoagulation treatment, rehabilitation, emotional stress, quality of life, and the associated outcomes for patients with pulmonary embolism. Guidelines suggest that the type and duration of treatment with anticoagulation should be based on prevalent risk factors. Recent studies demonstrate that an anticoagulant treatment that is longer than two years may be effective and safe for some patients. The evidence for extended treatment in cancer patients is limited. Careful consideration is particularly necessary for pulmonary embolisms in pregnancy, cancer, and at the end of life. The rehabilitation and prevention of unnecessary deconditioning, emotional distress, and a reduced quality of life is an important, but currently they are unmet priorities for many patients with a pulmonary embolism. Future research could demonstrate optimal anticoagulant therapy durations, follow-ups, and rehabilitation, and effective patient-centered decision making at the end of life. A patient preferences and shared decision making should be incorporated in their routine care when weighing the benefits and risks with primary treatment and secondary prevention.
    Language English
    Publishing date 2022-10-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11195970
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  7. Article ; Online: Hematuria in anticoagulated patients with atrial fibrillation and urologic cancer.

    Ording, Anne Gulbech / Søgaard, Mette / Skjøth, Flemming / Grove, Erik Lerkevang / Lip, Gregory Y H / Larsen, Torben Bjerregaard / Nielsen, Peter Brønnum

    Research and practice in thrombosis and haemostasis

    2022  Volume 6, Issue 1, Page(s) e12629

    Abstract: Background: Based on their renal excretion, direct oral anticoagulants (DOACs) may increase the risk of hematuria in patients with atrial fibrillation (AF) and urologic cancer compared with vitamin K antagonists.: Objectives: To examine the risk of ... ...

    Abstract Background: Based on their renal excretion, direct oral anticoagulants (DOACs) may increase the risk of hematuria in patients with atrial fibrillation (AF) and urologic cancer compared with vitamin K antagonists.
    Objectives: To examine the risk of bleeding associated with DOAC versus warfarin in patients with AF and urologic cancer.
    Methods: We conducted a Danish nationwide cohort study with individually linked registry data on patients with AF and active or a history of urologic cancer. We calculated crude rates per 100 person-years of hospital episodes of major bleeding and hematuria. We then compared rates of hematuria during the year after initial oral anticoagulation filled prescription by treatment regimen using inverse probability of treatment weighting and Cox regression.
    Results: The study population included 2615 patients with AF and urologic cancer (6.1% women; median age, 76 years) initiating a DOAC or warfarin. One-year risk of hematuria was 4.8% in the DOAC group and 4.7% in the warfarin group with a corresponding weighted hazard ratio (HR) of 1.21 (95% confidence interval [CI], 0.81-1.81). HRs for hematuria were generally similar in analyses restricted to patients treated with standard-dose DOAC and patients with active cancer. For those with cancer of the kidney, renal pelvis, ureter, and bladder, the HR was 0.82 (95% CI, 0.44-1.54). Results were mirrored for other bleeding events, whereas the risk for intracranial bleeding was lower with DOACs.
    Conclusion: In patients with AF and urologic cancer, there was a similar risk of hematuria associated with DOAC and warfarin treatment.
    Language English
    Publishing date 2022-01-13
    Publishing country United States
    Document type Journal Article
    ISSN 2475-0379
    ISSN (online) 2475-0379
    DOI 10.1002/rth2.12629
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  8. Article ; Online: Oral anti-coagulant treatment patterns in atrial fibrillation patients diagnosed with cancer: A Danish nationwide cohort study.

    Ording, Anne Gulbech / Søgaard, Mette / Nielsen, Peter Brønnum / Lip, Gregory Y H / Larsen, Torben Bjerregaard / Grove, Erik Lerkevang / Skjøth, Flemming

    British journal of haematology

    2022  Volume 197, Issue 2, Page(s) 223–231

    Abstract: Data on the use of oral anti-coagulants (OAC) for stroke prevention in cancer patients with atrial fibrillation (AF) are sparse. Nationwide cohort study of patients with AF (2012-2018) and an indication for OAC who were diagnosed with cancer at least one ...

    Abstract Data on the use of oral anti-coagulants (OAC) for stroke prevention in cancer patients with atrial fibrillation (AF) are sparse. Nationwide cohort study of patients with AF (2012-2018) and an indication for OAC who were diagnosed with cancer at least one year later (N = 12 756). We identified treatment with OAC at cancer diagnosis and the following year and described the incidence of discontinuing or switching between warfarin and direct oral anti-coagulants (DOACs). We also described baseline characteristics associated with OAC non-persistence. One third of the cancer patients received no OAC therapy, whereas 42% received warfarin and 24% received DOAC treatment. Switching incidence between OACs was higher for those receiving warfarin treatment (8.6%) than DOAC treatment (1.7%) within one year. Treatment discontinuation was 61% for warfarin and 26% for DOAC. Females were less likely to discontinue DOAC than males (ratio 0.77, 95% confidence interval: 0.66, 0.90). Increasing cancer stage was associated with discontinuation of DOAC, but not warfarin. OAC for stroke prevention in AF was used by two thirds of patients with newly diagnosed cancer. Switching between OACs and discontinuation was more common for warfarin than DOAC, and females had higher persistence with DOACs.
    MeSH term(s) Administration, Oral ; Anticoagulants ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Cohort Studies ; Denmark/epidemiology ; Female ; Humans ; Male ; Neoplasms/complications ; Neoplasms/drug therapy ; Neoplasms/epidemiology ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Warfarin
    Chemical Substances Anticoagulants ; Warfarin (5Q7ZVV76EI)
    Language English
    Publishing date 2022-02-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.18060
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  9. Article ; Online: Cancer risk in the siblings of individuals with major birth defects: a large Nordic population-based case-control study.

    Daltveit, Dagrun Slettebø / Klungsøyr, Kari / Engeland, Anders / Ekbom, Anders / Gissler, Mika / Glimelius, Ingrid / Grotmol, Tom / Madanat-Harjuoja, Laura / Ording, Anne Gulbech / Sørensen, Henrik Toft / Troisi, Rebecca / Bjørge, Tone

    International journal of epidemiology

    2023  Volume 52, Issue 6, Page(s) 1826–1835

    Abstract: Background: Individuals with major birth defects are at increased risk of developing cancer, indicating a common aetiology. However, whether the siblings of individuals with birth defects are also at an increased risk of cancer is unclear.: Methods: ... ...

    Abstract Background: Individuals with major birth defects are at increased risk of developing cancer, indicating a common aetiology. However, whether the siblings of individuals with birth defects are also at an increased risk of cancer is unclear.
    Methods: We used nationwide health registries in four Nordic countries and conducted a nested case-control study. We included 40 538 cancer cases (aged 0-46 years) and 481 945 population controls (matched by birth year and country), born between 1967 and 2014. The relative risk of cancer among individuals whose siblings had birth defects was computed with odds ratios (OR) and 95% confidence intervals (CIs), using logistic regression models.
    Results: In the total study population (aged 0-46 years), we observed no overall difference in cancer risk between individuals whose siblings had birth defects and those who had unaffected siblings (OR 1.02; 95% CI 0.97-1.08); however, the risk of lymphoid and haematopoietic malignancies was elevated (1.16; 1.05-1.28). The overall risk of childhood cancer (0-19 years) was increased for siblings of individuals who had birth defects (1.09; 1.00-1.19), which was mainly driven by lymphoma (1.35; 1.09-1.66), neuroblastoma (1.51; 1.11-2.05) and renal carcinoma (5.03; 1.73-14.6). The risk of cancer also increased with the number of siblings with birth defects (Ptrend = 0.008).
    Conclusion: Overall risk of cancer among individuals (aged 0-46 years) whose siblings had birth defects was not elevated, but the risk of childhood cancer (ages 0-19 years) was increased. Our novel findings are consistent with the common aetiologies of birth defects and cancer, such as shared genetic predisposition and environmental factors.
    MeSH term(s) Humans ; Siblings ; Case-Control Studies ; Logistic Models ; Carcinoma, Renal Cell ; Kidney Neoplasms
    Language English
    Publishing date 2023-08-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 187909-1
    ISSN 1464-3685 ; 0300-5771
    ISSN (online) 1464-3685
    ISSN 0300-5771
    DOI 10.1093/ije/dyad113
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  10. Article ; Online: Risk of recurrent cancer-associated venous thromboembolism: A Danish nationwide cohort study.

    Ording, Anne Gulbech / Nielsen, Peter Brønnum / Skjøth, Flemming / Overvad, Thure Filskov / Noble, Simon / Lash, Timothy L / Goldhaber, Samuel Zachery / Christensen, Thomas Decker / Larsen, Torben Bjerregaard / Søgaard, Mette

    International journal of cardiology

    2023  Volume 390, Page(s) 131271

    Abstract: Background: Predictive factors for recurrent cancer-associated venous thromboembolism have been inconsistent across previous studies. To provide data for improved risk stratification, we described the risk of recurrent venous thromboembolism overall and ...

    Abstract Background: Predictive factors for recurrent cancer-associated venous thromboembolism have been inconsistent across previous studies. To provide data for improved risk stratification, we described the risk of recurrent venous thromboembolism overall and across age, sex, calendar period, cancer type, Ottawa risk score, cancer stage, and cancer treatment in a nationwide cohort of patients with active cancer.
    Methods: Using Danish administrative registries, we identified a cohort of all adult patients with active cancer and a first-time diagnosis of venous thromboembolism during 2003-2018. We accounted for the competing risk of death and calculated absolute risks of recurrent venous thromboembolism at six months.
    Results: The population included 34,072 patients with active cancer and venous thromboembolism. Recurrence risks at six months were higher for patients with genitourinary cancer (6.5%), lung cancer (6.1%), gastrointestinal cancer (5.6%), brain cancer (5.2%), and hematological cancer (5.1%) than for patients with gynecological cancer (4.7%), breast cancer (4.1%), and other cancer types (4.8%). Recurrence risks were similar for men (5.2%) and women (4.9%), with and without chemotherapy (5.1%), across Ottawa risk score group (low: 5.0%; high: 5.1%) and across calendar periods but increased with increasing cancer stage. The overall six-month all-cause mortality risk was 26%, and highest for patients with lung cancer (49%) and lowest among breast cancer patients (4.1%).
    Conclusions: Six-month recurrence risk after first-time cancer-associated venous thromboembolism was high and varied by cancer type and patient characteristics. Refining risk stratification for recurrence may improve decision-making regarding treatment duration after cancer-associated thromboembolism.
    MeSH term(s) Adult ; Male ; Humans ; Female ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/epidemiology ; Cohort Studies ; Neoplasm Recurrence, Local ; Breast Neoplasms ; Lung Neoplasms ; Denmark/epidemiology
    Language English
    Publishing date 2023-08-15
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2023.131271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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