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3/9/26

ABSTRACT

BACKROUND: Venous thromboembolic disease (VTED) is a frequent cause of hospitalization and mortality. Whole blood viscosity (WBV) participates in the pathogenesis of thrombosis.

OBJECTIVE: To identify the most frequent etiologies and their association with WBV index (WBVI) in hospitalized patients with VTED.

MATERIAL AND METHODS: Observational, cross-sectional, retrospective, analytical study, Group 1: cases (patients diagnosed with VTED) and Group 2: controls without thrombosis. Risk factors for VTED were described and WBVI was calculated from total proteins and hematocrit. Descriptive and inferential statistics were used with Chi-squared test, Fisher's exact test, Mann Whitney U test, bivariate and multivariate logistic regression analysis.

RESULTS: We included 146 patients and 148 controls, age 46.3 ±17.7 vs. 58 ± 18.2 years, of both sexes (female, 65.1%). The most frequent etiology was neoplastic (23.3%), followed by diseases with cardiovascular risk (17.8%). Independent risk factors for VTED were age, chronic kidney disease, presence of liver disease or solid neoplasia. WBVI was similar in patients with VTED as in those without thrombosis. We found an association of the presence of deep vein thrombosis and diseases with cardiovascular risk (p = 0.040).

CONCLUSIONS: The presence of chronic kidney disease, liver disease, and solid neoplasia are independent risk factors for VTED. The WBVI is a simple and rapid diagnostic tool in the evaluation of patients with VTED.

PMID:37200530

02:33

PubMed articles on: Cancer & VTE/PE

American Society of Hematology 2023 Guidelines for Management of Venous Thromboembolism: Thrombophilia Testing

Blood Adv. 2023 May 17:bloodadvances.2023010177. doi: 10.1182/bloodadvances.2023010177. Online ahead of print.

ABSTRACT

BACKGROUND: Hereditary and acquired thrombophilia are risk factors for venous thromboembolism (VTE). Whether testing helps in guiding management decisions is controversial.

OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision-making about thrombophilia testing.

METHODS: ASH formed a multidisciplinary guideline panel covering clinical and methodological expertise and minimizing bias from conflicts of interest. The McMaster University GRADE Centre provided logistical support, performed systematic reviews, and created evidence profiles and evidence-to-decision tables. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used. Recommendations were subject to public comment.

RESULTS: The panel agreed on 23 recommendations regarding thrombophilia testing and associated management. Nearly all recommendations are based on very low certainty in the evidence due to modeling assumptions.

CONCLUSIONS: The panel issued a strong recommendation against testing the general population before starting combined oral contraceptives (COC), and conditional recommendations for thrombophilia testing in the following scenarios: a) patients with VTE associated with non-surgical major transient or hormonal risk factors; b) patients with cerebral or splanchnic venous thrombosis, in settings where anticoagulation would otherwise be discontinued; c) individuals with a family history of antithrombin, protein C or protein S deficiency when considering thromboprophylaxis for minor provoking risk factors, and for guidance to avoid COC/HRT; d) pregnant women with a family history of high-risk thrombophilia types; e) patients with cancer at low or intermediate risk of thrombosis and with a family history of VTE. For all other questions, the panel provided conditional recommendations against testing for thrombophilia.

PMID:37195076 | DOI:10.1182/bloodadvances.2023010177