Abstract 1095: Association Between Active Cancer And The Risk Of Thrombotic And Cardiovascular Outcomes In Patients With Covid-19

Background: Active cancer and COVID-19 are each independently associated with excess risk of thrombotic and cardiovascular outcomes. Data are limited regarding the risk of these outcomes in patients with both active cancer and COVID-19. Aim: To examine the association between active cancer and thrombotic and cardiovascular outcomes among patients with COVID-19. Methods: Data from patients with confirmed COVID-19 from the multicenter CORONA-VTE Network registry were used. Active cancer was defined as having a malignancy diagnosis within the past year or receiving related treatment. Outcomes were adjudicated and included (1) a composite of venous and arterial thromboembolism and (2) a composite of major adverse cardiovascular events, including thromboembolism, heart failure, myocarditis, new atrial fibrillation, and cardiovascular death within 90 days of COVID-19 diagnosis. Results: The registry included 3,844 inpatients and 6,576 outpatients, of whom 247 (6.4%) and 199 (3.0%) had active cancer, respectively. For inpatients with and without cancer, the cumulative incidences of thromboembolism were 8.6% and 8.3%, respectively (hazard ratio HR:1.05; 95% Confidence Interval [CI: 0.68-1.64, P = 0.82) (Figure). The corresponding cumulative incidences of cardiovascular events were 16.1% and 15.3% (HR: 1.04; 95% CI: 0.75-1.45, P = 0.79). For outpatients with and without cancer, the cumulative incidences of thromboembolism were 3.6% and 1.2%, respectively (HR: 3.07; 95% CI: 1.41-6.67, P = 0.005). Corresponding cumulative incidences of cardiovascular events were 4.6% and 1.9% (HR: 2.47; 95% CI: 1.25-4.86, P = 0.009). Conclusions: There was no significant difference in the incidence of thrombotic or cardiovascular events among inpatients with and without active cancer, yet outpatients with COVID-19 and active cancer demonstrated a significantly increased hazard of thrombotic and cardiovascular events compared with non-cancer outpatients.