Although Asian population has low risk of venous thromboembolism (VTE), its increasing prevalence and predictor in cancer patients remain unclear. We performed a prospective observational study to investigate the prevalence and to attempt to predict high VTE risk patients using coagulation markers.
We enrolled patients with malignancy admitted to Tonan Hospital between April and December 2014 to receive new chemotherapy regimen without prophylactic anticoagulation. All patients were examined for VTE by computed tomography and whole-leg compression ultrasonography at the beginning of chemotherapy and three months later. We also measured coagulation markers including soluble fibrin monomer complex (SFMC) and thrombin-antithrombin complex (TAT) levels, at the beginning.
Of the 97 patients, the majority (67%) had distal metastases, and some (10%) were immobilized. The most common malignancies were colorectal (26%), breast (23%), and stomach (19%) cancers. VTE was detected in 29 patients (31%), and all were asymptomatic. Distal deep vein thrombosis of the leg was found in 18, proximal deep vein thrombosis in 12 patients including 3 of catheter-related thrombosis and also 3 of pulmonary embolism. VTE was significantly more common in patients with reduced mobility for at least three days (odds ratio [OR] 6.89; P = 0.007). VTE tended to be high in patients with 6 to 12 months from onset time (OR 2.70; P = 0.174) and high level of both SFMC [≥ 7.0 Âµg/mL] and TAT [≥ 3.0 Âµg/mL] (OR 2.25; P = 0.200).
The prevalence of VTE in hospitalized Japanese cancer patients receiving chemotherapy was high especially in patients with reduced mobility. The combination of high SFMC and TAT levels might be a predictor.
Clinical trial identification
Y. Tsuji: lecture fees from Ono Pharmaceutical Co. Ltd. All other authors have declared no conflicts of interest.