Key result
In patients with active cancer, D-dimer >1121 ng/mL was associated with an increased likelihood of disease progression within 6 months (OR 10.5; 95% CI 1.4-81.0; p=0.014).
Why the study?
Differences in thrombogenesis mechanisms between malignant neoplasms and atherosclerosis warranted a comparative study of coagulation activation and endothelial damage markers to identify shared and distinct features.
Do markers of coagulation and inflammation predict adverse events differently in patients with active cancer versus advanced atherosclerosis?
Cohort (n=80)
Do markers of coagulation and inflammation predict adverse events differently in patients with active cancer versus advanced atherosclerosis?
Endothelial damage and coagulation activation markers differ in their prognostic value, with D-dimer and VWF predicting outcomes in cancer, while VWF and GDF-15 predict outcomes in advanced atherosclerosis.
Differences in thrombogenesis mechanisms between malignancy and atherosclerosis may require distinct antithrombotic approaches; leaves open targeted interventions in high-risk patients.
Introduction. Thrombotic complications (TC) in different vascular systems dictate the fate of high-risk patients. In cardiological practice, patients with advanced atherosclerotic vascular disease (MFA) represent the most vulnerable group. Malignant neoplasm (MN) is one of the most significant risk factors for developing TCs, especially in the context of antineoplastic therapy. The presence of significant differences in the mechanisms of thrombogenesis in malignant neoplasms and atherosclerosis determines the appropriateness of a comparative study of markers of coagulation activation and endothelial damage in order to identify common features and differences specific to each pathology. Aim. To examine markers of coagulation activation and growth factors in active cancer and advanced atherosclerotic vascular disease, to identify their common features and differences specific to each pathology. Materials and methods. A total of 22 patients with MN (Group 1) and 58 patients with MFA (Group 2) were enrolled in the study. The assessed biomarkers included: von Willebrand factor (VWF), D-dimer, growth differentiation factor-15 (GDF-15) and vascular endothelial growth factor A (VEGF-A). Results. Patients with MN had an increased likelihood of disease progression within 6 months at D-dimer level > 1121 ng/mL (OR = 10.5; 95% CI 1.4–81.0, p = 0.014) or VWF > 189% (OR 10.5, 95% CI 1.36–81.0, p = 0.014); the likelihood of death within two years of follow-up at D-dimer level > 1121 ng/mL (OR = 7.0; 95% CI 0.97–50.57, p = 0.04), or VWF > 203% (OR = 10, 5, 95% CI 1.36–81.06, p = 0.014). In patients with MFA, the likelihood of prognosis determining events within one-year of follow-up was determined by increased levels of VWF > 157% (OR = 9.2, 95% CI 1.02–82.8, p = 0.048) and GDF-15 > 1548 pg/ml (OR = 5.7; 95% CI 1.09–29.5, p = 0.04). Conclusions. Endothelial damage and coagulation activation are more pronounced in patients with MN than in patients with MFA. In patients with malignant neoplasms, the outcomes were associated with D-dimer and VWF levels, and in patients with MFA – with VWF and GDF-15 levels.
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Fedotkina et al. (2023) conducted a cohort in Active cancer and advanced atherosclerotic vascular disease (n=80). Elevated D-dimer (> 1121 ng/mL) vs. Lower D-dimer levels was evaluated on Disease progression within 6 months in patients with malignant neoplasms (OR 10.5, 95% CI 1.4-81.0, p=0.014). In patients with active cancer, D-dimer >1121 ng/mL was associated with an increased likelihood of disease progression within 6 months (OR 10.5; 95% CI 1.4-81.0; p=0.014).
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