Interv Akut Kardiol. 2023;22(2):74-78 | DOI: 10.36290/kar.2023.021

Cancer-associated thromboembolism

doc. MUDr. Debora Karetová, CSc.

II. interní klinika kardiologie a angiologie, Všeobecná fakultní nemocnice a 1. lékařská fakulta UK, Praha

Cancer is a major risk factor for venous thromboembolism (VTE). The incidence of cancer-associated thrombosis (CAT) in cancer patients is increasing due to improved antitumor treatment options and the prolongation of patients' lives. It constitutes up to 25% of all VTE cases. CAT causes higher morbidity and mortality, as well as a deterioration in the quality of life. Daily subcutaneous low-molecular-weight heparin (LMWH) has been the standard treatment for CAT for years. Data on the safety and efficacy of direct oral anticoagulants (DOACs) in this population have emerged in recent years and have been included in recent international guidelines. For the acute-phase treatment, the anti-Xa inhibitors (apixaban, edoxaban, rivaroxaban) showed better efficacy than LMWH in preventing VTE recurrence; however, rivaroxaban and edoxaban were also associated with an increased risk of bleeding events. Recent guidelines recommend DOACs for the treatment of CAT in selected cancer patients (eg, low bleeding risk, no luminal gastrointestinal or genitourinary malignancies, no interfering medications).

Keywords: cancer-associated thrombosis, prevention, diagnosis, treatment, low-molecular-weight heparins, apixaban, edoxaban, rivaroxaban.

Accepted: May 9, 2023; Published: May 9, 2023  Show citation