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Arterial thromboembolism in patients with cancer
fatal myocardial infarctions, 16 (33.3%) ischemic strokes, 12 (25.0%) peripheral arterial events, and one (2.1%) fatal myocardial infarction were observed. Detailed informa- tion on cancer patients with ATE is listed in Table 2. The cumulative 3-, 6-, 12-, and 24-month ATE risks were 0.9% (95%CI: 0.6-1.4), 1.1% (0.7-1.7), 1.7% (1.2-2.4), and 2.6% (2.0-3.4), respectively (Figure 1). While the rate of VTE was highest during the first six months of follow up and strongly declined thereafter, ATE events did not have a peak incidence, but rather occurred at a relatively constant rate (Figure 2).
Table 1. Baseline characteristics of the total study population.
Risk factors for ATE in patients with cancer
In univariable competing risk regression analysis, male sex [subdistribution hazard ratio (SHR)=2.9, 95%CI: 1.5- 5.6; P=0.002], higher age (SHR per 10 year increase=1.5, 1.2-1.7; P<0.001), hypertension (SHR=3.1, 1.7-5.5; P<0.001), diabetes (SHR=2.2, 1.2-4.4; P=0.020), a positive
Table 2. Baseline characteristics of patients with ATE.
N. of patients %
Median age at study entry, years 66
First to third quartile
Median body mass index, kg/m2 26.3
60-69 23.2-29.0
11 22.9 37 77.1
20 41.7 13 27.1 3 6.3 12 25.0
15 45.8 0 0.0 5 10.4 7 14.6 3 6.3 8 16.7 2 4.2 2 4.2 0 0.0 4 8.4 2 4.2
19 44.2 14 32.6 10 23.3
19 40.4 12 25.5 16 34.0 31 64.6 11 22.9 12 25.0
8 16.7 2 4.2 22 45.8
14 29.2
N. of patients
Median age at study entry, years 61
First to third quartile 52-68
%
First to third quartile Sex
Female
Male
Type of arterial thromboembolic event
Myocardial infarction
Major stroke
Minor stroke
Peripheral arterial occlusion
Site of cancer Lung
Breast Lymphoma
Brain
Colorectal Prostate Pancreas Stomach
Multiple myeloma Kidney
Others
Progression of tumor
Localized
Distant metastasis Not classifiablea
Smoking status
Smoker
Ex-smoker (>1-year non-smoker) Non-smoker
Hypertension at study entry
Diabetes at study entry
Known atherosclerotic cardiovascular
disease at study entry
Dyslipidemia at study entry
History of venous thromboembolism*
Platelet aggregation inhibitor use
at study entry
Lipid lowering agent use at study entry
Median body mass index, kg/m2 First to third quartile
Sex
Female
Male
Site of cancer
Lung
Breast Lymphoma
Brain
Colorectal Prostate Pancreas Stomach
Multiple myeloma Kidney
Others
Progression of tumor Localized
Distant metastasis Not classifiablea
Smoking status
Smoker
Ex-smoker (>1-year non-smoker) Non-smoker
Hypertension at study entry
Diabetes at study entry
Known atherosclerotic cardiovascular disease at study entry
Dyslipidemia at study entry
History of venous thromboembolism* Platelet aggregation inhibitor use
at study entry
Lipid lowering agent use at study entry
25.1 22.4-28.3
860 45.7 1020 54.3
319 17.0 276 14.7 265 14.1 248 13.2 186 9.9 157 8.4 133 7.1 65 3.5 50 2.7 45 2.4 136 7.2
629 35.7 627 35.6
506
28.7
546 31.6 313 18.1 867 50.2 704 37.5 223 11.9 159 8.5
222 11.9 91 4.8 280 14.9
238 12.7
Continuous data are reported as medians with first and third quartiles. Categorical variables are given as absolute frequencies and percentages. aData on body mass index,progression of tumor,and smoking status are missing in 6,118,and 154 patients, respectively.*Definedasvenousthromboembolism(VTE) thathadoccurredmore than three months before study inclusion. N: number.
Continuous data are reported as medians with first and third quartiles. Categorical variables are given as absolute frequencies and percentages. aData on progression of tumor are missing in 5 patients. Data on smoking status are missing in one patient. *Defined as venous thromboembolism (VTE) that had occurred more than three months before study inclusion. N: number.
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