title: Outcome during and after anticoagulant therapy in cancer patients with incidentally found pulmonary embolism.
abstract: Current guidelines suggest treating cancer patients with incidental pulmonary embolism comparably to patients with symptomatic pulmonary embolism.We used the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) registry to compare the rate of major bleeding and symptomatic pulmonary embolism during the course of anticoagulation and after its discontinuation in cancer patients with incidental pulmonary embolism.As of March 2016, 715 cancer patients with incidental pulmonary embolism had been enrolled in RIETE. During the course of anticoagulant therapy (mean 235 days), the rate of major bleeding was higher than the rate of symptomatic pulmonary embolism (10.1 (95% CI 7.48-13.4) versus 3.17 (95% CI 1.80-5.19) events per 100 patient-years, respectively), and the rate of fatal bleeding was higher than the rate of fatal pulmonary embolism (2.66 (95% CI 1.44-4.52) versus 0.66 (95% CI 0.17-1.81) deaths per 100 patient-years, respectively). After discontinuing anticoagulation (mean follow-up 117 days), the rate of major bleeding was lower than the rate of symptomatic pulmonary embolism (3.00 (95% CI 1.10-6.65) versus 8.37 (95% CI 4.76-13.7) events per 100 patient-years, respectively); however, there were no differences in the rate of fatal events at one death each.The risk/benefit ratio of anticoagulant therapy in cancer patients with incidental pulmonary embolism is uncertain and must be evaluated in further studies.
authors.affiliation: Dept of Internal Medicine, Consorcio Hospitalario Provincial de Castellón, Ceu Cardenal Herrero University, Castellón, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Peris
authors.affiliation: Respiratory Dept, Ramón y Cajal Hospital and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Jiménez
authors.affiliation: Dept of Internal Medicine, Hospital Universitario de Vinalopó, Alicante, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Maestre
authors.affiliation: Dept of Medical Oncology, IDIBAPS/Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Font
authors.affiliation: Division of Vascular Surgery, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Tafur
authors.affiliation: Dept of Angiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mazzolai
authors.affiliation: Dept of Internal Medicine, Hospital El Vendrell, Tarragona, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Xifre
authors.affiliation: Dept of Cardiology, Ospedale Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors.forename: Andris
authors.initials: A
authors.lastname: Skride
authors.affiliation: Dept of Clinical and Experimental Medicine, University of Insubria, Varese, Italy.
authors.forename: Francesco
authors.identifier: 0000-0003-4195-7725
authors.initials: F
authors.lastname: Dentali
authors.affiliation: Dept of Internal Medicine, Hospital de Badalona Germans Trias i Pujol, Universidad Católica de Murcia, Murcia, Spain mmonreal.germanstrias@gencat.cat.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000150:complications* / Q000188:drug therapy* / Q000517:prevention & control; D012042:Registries; D018570:Risk Assessment; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants