Key result
Concomitant malignancy and higher discharge D-dimer predict mortality and MACE after PE.
Why the study?
Venous thromboembolism is an increasingly prevalent cancer comorbidity, but its clinical picture has not been thoroughly investigated.
Observational (n=259)
No
In patients treated for pulmonary embolism, D-dimer levels at discharge independently predict long-term mortality, highlighting its prognostic value especially in the context of cancer-associated thrombosis.
Answers are grounded in this paper and cite their sources.
May aid post-PE risk stratification by malignancy and D-dimer; leaves open prospective validation before guiding interventions.
Venous thromboembolism (VTE) is a common comorbidity of cancer, often referred to as cancer-associated thrombosis (CAT). Even though its prevalence has been increasing, its clinical picture has not been thoroughly investigated. In this single-center retrospective observational study, 259 patients who were treated for pulmonary embolism (PE) between January 2015 and December 2020 were available for analysis. The patients were divided by the presence or absence of concomitant malignancy, and those with malignancy (N = 120, 46%) were further classified into active (N = 40, 15%) and inactive groups according to the treatment status of malignancy. In patients with malignancy, PE was more often diagnosed incidentally by computed tomography or D-dimer testing, and the proportion of massive PE was lower. Although D-dimer levels overall decreased after the initiation of anticoagulation therapy, concomitant malignancy was independently associated with higher D-dimer at discharge despite the lower severity of PE at onset. The patients with malignancy had a poor prognosis during post-discharge follow-up. Active malignancy was independently associated with major adverse cardiovascular events (MACE) and major bleeding. D-dimer at discharge was an independent predictor of mortality even after adjustment for malignancy. This study's findings suggest that CAT-PE patients might have hypercoagulable states, which can potentially lead to a poorer prognosis.
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Himeno et al. (2023) conducted an observational in Pulmonary embolism (n=259). Concomitant malignancy and D-dimer levels vs. Absence of malignancy and lower D-dimer levels was evaluated on Mortality, major adverse cardiovascular events (MACE), and major bleeding. In 259 patients treated for pulmonary embolism, concomitant malignancy (46%) and higher D-dimer at discharge were independent predictors of mortality and major adverse cardiovascular events.
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