title: Venous thromboembolism and persistent pulmonary hypertension in cancer patients: a cross-sectional study.
abstract: BACKGROUND
  Cancer patients are at increased risk for venous thromboembolism (VTE).
  
  
  OBJECTIVE
  This monocenter cross-sectional study prospectively assessed the association between a history of ≥1 VTE episode and the presence of pulmonary hypertension (PH) among cancer patients presenting with pulmonary or cardiac symptoms.
  
  
  METHODS
  A consecutive series of 583 patients underwent a diagnostic work-up for heart and lung disease. PH was diagnosed if a patient's peak systolic pressure gradient across the tricuspid valve was ≥35 mmHg, as measured by echocardiography. Using multiple logistic regression analysis, the association between VTE and PH was assessed, following adjustments for age, the presence of severe airway obstruction, atrial fibrillation and left heart diseases.
  
  
  RESULTS
  The prevalence values for PH (n = 90) and a history of VTE (n = 72) were 15.4 and 12.3 %, respectively. The median time interval between the first VTE episode and referral was 43 months. The odds of PH was higher in the subgroup with VTE (19/72; 26.4 %) than that without VTE (71/511; 13.9 %) in the unadjusted analysis [odds ratio (OR) 2.2, 95 % confidence interval (CI) 1.2, 4.0] and the adjusted model [OR 2.4, 95 % CI 1.2, 4.5]. The risk of PH did not depend on the time interval between VTE and referral. Older age and the presence of severe airway obstruction, atrial fibrillation, and left heart diseases were also associated with an increased odds of PH.
  
  
  CONCLUSIONS
  In cancer patients presenting with cardiac or pulmonary symptoms, previous VTE is associated with an increased risk of persistent PH.
authors: Department of Cardiology, Pulmonology and Critical Care Medicine, Offenburg Hospital, Weingartenstrasse 70, D-77654 Offenburg, Germany.
authors: Siegfried
authors: 0000-0002-0681-5222
authors: S
authors: Wieshammer
authors: Institute of Epidemiology and Medical Biometry, University of Ulm, D-89075 Ulm, Germany.
authors: Jens
authors: J
authors: Dreyhaupt
authors: Department of Cardiology, Pulmonology and Critical Care Medicine, Offenburg Hospital, Weingartenstrasse 70, D-77654 Offenburg, Germany.
authors: Dirk
authors: D
authors: Müller
authors: Department of Radiation Oncology, Offenburg Hospital, D-77654 Offenburg, Germany.
authors: Felix
authors: F
authors: Momm
authors: Department of Medical Oncology, Offenburg Hospital, D-77654 Offenburg, Germany.
authors: Andreas
authors: A
authors: Jakob
keywords: Cancer; Heart disease; Pulmonary hypertension; Venous thromboembolism