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 235â 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 100â 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 100â patient-years, respectively). After discontinuing anticoagulation (mean follow-up 117â 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 100â 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.
Subject(s)
Anticoagulants/therapeutic use , Neoplasms/complications , Neoplasms/drug therapy , Pulmonary Embolism/complications , Pulmonary Embolism/drug therapy , Aged , Anticoagulants/adverse effects , Female , Hemorrhage , Humans , Incidental Findings , Male , Middle Aged , Pulmonary Embolism/prevention & control , Registries , Risk Assessment , Thrombolytic Therapy , Treatment OutcomeSubject(s)
Antidepressive Agents/adverse effects , Pulmonary Eosinophilia/chemically induced , Sertraline/adverse effects , Acute Disease , Adult , Bronchoalveolar Lavage , Bronchoalveolar Lavage Fluid/cytology , Female , Glucocorticoids/therapeutic use , Humans , Methylprednisolone/therapeutic use , Pulmonary Eosinophilia/drug therapyABSTRACT
No disponible