Active cancer is a known risk factor for arterial venous and arterial thrombosis. MedUni Vienna has now performed the first population-based study to analyse the risk of venous thromboembolism, pulmonary embolism, heart attack and stroke. This country-wide analysis showed that the relative risk of arterial and venous thromboembolism is elevated in cancer patients of all age groups.
Up until now, no large-scale population-based data were available for the thrombosis risk in the entire population of people with cancer or the risk within specific types of cancer. Within the framework of the nation-wide analysis that has now been performed, ICD-10 diagnosis codes were extracted from the database of the Austrian Association of Social Security Providers. All publicly insured persons in Austria from the years 2006 – 2007 was included in the analysis.
This enabled the MedUni Vienna research team, led by Ella Grilz, Ingrid Pabinger (member of the management of the Comprehensive Cancer Center/Executive Board) and Cihan Ay from the Division of Hematology and Hemastasology of the Department of Medicine I, to determine the risk of arterial and venous thromboembolism in cancer patients from all age groups more accurately than had been possible in previous studies: "We were able to establish that the relative risk of both arterial and venous thromboembolism was significantly higher in patients with cancer in all age groups than in people of the same age without cancer," says lead author Ella Grilz, explaining the new findings. "The relative risk of thromboembolism was highest in younger patients, which could point to a direct effect of cancer and/or cancer treatment."
The recent study, which was published in the European Heart Journal, showed that patients with cancer have a 6.88 times higher relative risk of arterial thromboembolism (heart attack, stroke, peripheral vascular occlusion) and 14.91 times higher relative risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism). While the relative risk for arterial thromboembolism was highest in patients with urinary tract malignancies, patients with cancer of the mesothelium/soft tissue had the highest relative risk of venous thromboembolism.
The study also showed that approximately 11% of all arterial and 20% of all venous thromboembolisms occur in patients with cancer. Cihan Ay comments: "The results not only highlight the high frequency of venous thromboembolism and the additional burden this represents for cancer patients but also support the premise that a cancer diagnosis can favour the occurrence of heart attack or stroke. In future we must therefore make medical professionals more aware of cancer-associated thrombosis, since this will become increasingly prevalent in an ageing population."
Service: European Heart Journal
“Relative Risk of Arterial and Venous Thromboembolism in Persons with Cancer versus Persons without Cancer – A Nation-Wide Analysis.” Ella Grilz, Florian Posch, Stephan Nopp, Oliver Königsbrügge, Irene M. Lang, Peter Klimek, Stefan Thurner, Ingrid Pabinger, Cihan Ay. LINK