- 著者
-
Yuji Nishimoto
Yugo Yamashita
Kitae Kim
Takeshi Morimoto
Syunsuke Saga
Hidewo Amano
Toru Takase
Seiichi Hiramori
Maki Oi
Masaharu Akao
Yohei Kobayashi
Mamoru Toyofuku
Toshiaki Izumi
Tomohisa Tada
Po-Min Chen
Koichiro Murata
Yoshiaki Tsuyuki
Tomoki Sasa
Jiro Sakamoto
Minako Kinoshita
Kiyonori Togi
Hiroshi Mabuchi
Kensuke Takabayashi
Yusuke Yoshikawa
Hiroki Shiomi
Takao Kato
Takeru Makiyama
Koh Ono
Yukihito Sato
Takeshi Kimura
on behalf of the COMMAND VTE Registry Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.84, no.11, pp.2006-2014, 2020-10-23 (Released:2020-10-23)
- 参考文献数
- 33
- 被引用文献数
-
21
Background:Patients with cancer-associated venous thromboembolism (VTE) are at high risk for recurrent VTE and are recommended to receive prolonged anticoagulation therapy if they are at a low risk for bleeding. However, there are no established risk factors for bleeding during anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter retrospective registry enrolling 3,027 consecutive patients with acute symptomatic VTE among 29 Japanese centers. The present study population consisted of 592 cancer-associated VTE patients with anticoagulation therapy. We constructed a multivariable Cox proportional hazard model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the potential risk factors for major bleeding. During a median follow-up period of 199 days, major bleeding occurred in 72 patients. The cumulative incidence of major bleeding was 5.8% at 3 months, 13.8% at 1 year, 17.5% at 2 years, and 28.1% at 5 years. The most frequent major bleeding site was gastrointestinal tract (47%). Terminal cancer (adjusted HR, 4.17; 95% CI, 2.22–7.85, P<0.001), chronic kidney disease (adjusted HR, 1.89; 95% CI 1.06–3.37, P=0.031), and gastrointestinal cancer (adjusted HR, 1.78; 95% CI, 1.04–3.04, P=0.037) were independently associated with an increased risk of major bleeding.Conclusions:Major bleeding events were common during anticoagulation therapy in real-world cancer-associated VTE patients. Terminal cancer, chronic kidney disease, and gastrointestinal cancer were the independent risk factors for major bleeding.