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KMID : 1011220210070010014
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Clinical & Experimental Thrombosis and Hemostasis
2021 Volume.7 No. 1 p.14 ~ p.19
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Recurrence of Cancer-associated Venous Thromboembolism between 2009 and 2013: A Nationwide Korean Study
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Hwang Hun-Gyu
Lee Ju-Hyun
Hong Jun-Shik
Kim Sang-A
Kim Yang-Ki
Kim Myung-Shin
Bang Soo-Mee
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Abstract
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Purpose: Venous thromboembolism (VTE) is a frequent complication in patients with cancer, but the recurrence rate remains unclear in treatment of cancer-associated VTE (CAT). We examined the recurrence rates in patients with CAT and compared them with those of non-cancer-associated VTE (NCAT) patients in Republic of Korea.
Methods: We obtained medical claims data on patients with CAT and NCAT from the Health Insurance Review and Assessment (HIRA) database between 2009 and 2013, which included age, sex, and anticoagulant use history.
Results: Among 59,626 index cases, 19,725 (33.1%) had diagnostic codes for cancer and VTE. The proportions of male were 53.8% and 41.9%, and the proportion of pulmonary embolism (PE) with or without deep vein thrombosis (DVT) were 60.4% and 59.9% in CAT and NCAT group, respectively . The rate of recurrent VTE was significantly higher in the CAT than in the NCAT group (7.08% vs. 6.54%; relative risk [RR]: 1.083; 95% confidence interval [CI]: 1.017?1.153; P= 0.013) despite a shorter duration of follow-up in the CAT patients. Upon subgroup analysis, the recurrent VTE rate in the CAT group was significantly higher than that in the NCAT group for patients ≥ 60 years of age (6.96% vs. 5.92; RR: 1.177, 95% CI: 1.090?1.270; P< 0.0001); in females (7.3% vs. 6.3%; RR: 1.144, 95% CI: 1.047?1.250; p< 0.003); and in the PE group (7.7% vs. 6.8%; RR: 1.125, 95% CI: 1.041?1.216; P< 0.003).
Conclusion: Recurrence rate in patients with CAT was significantly higher than that of NCAT patients. A subgroup analysis revealed that the recurrence rates in CAT versus NCAT were significantly increased in patients ≥ 60 years, in the PE group, and in the female group.
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KEYWORD
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Cancer, Venous thromboembolism, Pulmonary embolism, Deep vein thrombosis, Anticoagulants, Incidence, Recurrence
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