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Malignancy-Associated Pulmonary Embolism: Mortality, Recurrence, and Bleeding Risks.

Daniela Maria Nemțuț1, Florica Voiță-Mekeres1,2, Ruxandra Ulmeanu1

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Summary
This summary is machine-generated.

Cancer patients with pulmonary embolism (PE) face higher late mortality, influenced by age and cancer status, not early outcomes. NT-proBNP may aid risk stratification in PE patients.

Keywords:
NT-proBNPcancer-associated thrombosisdirect oral anticoagulantspulmonary embolism

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Area of Science:

  • Cardiology
  • Oncology
  • Pulmonology

Background:

  • Pulmonary embolism (PE) is a significant cause of death, with outcomes affected by patient factors and treatment.
  • Direct oral anticoagulants (DOACs) are increasingly used, but real-world data in cancer patients with PE is limited.
  • Comparing cancer and non-cancer patients with PE is crucial for understanding differential outcomes.

Purpose of the Study:

  • To compare demographics, clinical features, treatment strategies, and outcomes of oncologic patients with acute PE versus non-cancer patients.
  • To identify factors influencing early and late mortality in PE patients with and without cancer.
  • To evaluate the role of NT-proBNP as a biomarker for risk stratification in PE.

Main Methods:

  • A multicentric retrospective cohort study of 226 adult patients with acute PE (106 cancer, 120 non-cancer) from January 2019 to December 2021.
  • Data collected included demographics, comorbidities, laboratory biomarkers (NT-proBNP, D-dimer), anticoagulation strategy (VKA, DOAC), and outcomes.
  • Primary outcomes were all-cause mortality at ≤30 days and 31-365 days; secondary outcomes included PE recurrence and bleeding events.

Main Results:

  • Cancer patients were older and had higher NT-proBNP levels, while non-cancer patients had higher D-dimer levels.
  • DOAC use was less frequent in cancer patients (40.6%) compared to non-cancer patients (65.0%).
  • Early mortality was similar, but late mortality was significantly higher in cancer patients (38.7% vs. 3.3%). Multivariable analysis linked cancer status and age to higher late mortality.

Conclusions:

  • Prompt anticoagulation is associated with reduced early mortality in PE patients.
  • Late mortality differences between cancer and non-cancer PE patients are significantly influenced by age and cancer status.
  • NT-proBNP may be a valuable biomarker for risk stratification in PE, warranting further investigation in prospective studies.