Patients with cancer face heightened short-term risk of arterial thromboembolism
There is a markedly increased short-term risk of arterial thromboembolism among patients with incident cancer, a recent study has found.
To improve understanding of the epidemiological relationship between arterial thromboembolism and cancer, researchers identified patients with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, pancreatic or gastric cancer or non-Hodgkin lymphoma from 2002 to 2011 using the Surveillance Epidemiology and End Results–Medicare linked database.
The authors individually matched patients by demographics and comorbidities to a Medicare enrolee without cancer, and followed each pair through 2012.
Arterial thromboembolism, defined as myocardial infarction or ischaemic stroke, was identified using validated diagnosis codes. Competing risk survival statistics was used to calculate cumulative incidence rates. Cox hazards analysis was performed to compare rates between groups at discrete time points.
In total, 279,719 pairs of patients with cancer and matched controls were included. Patients with cancer had higher 6-month cumulative incidence of arterial thromboembolism than controls (4.7 percent; 95 percent CI, 4.6 to 4.8 percent vs 2.2 percent; 2.1 to 2.2 percent; hazard ratio [HR], 2.2; 2.1 to 2.3).
The 6-month cumulative incidence of myocardial infarction was 2.0 percent (1.9 to 2.0 percent) vs 0.7 (0.6 to 0.7 percent) in patients with cancer and control patients, respectively (HR, 2.9; 2.8 to 3.1). The 6-month cumulative incidence of ischaemic stroke was 3.0 percent (2.9 to 3.1 percent) in patients with cancer vs 1.6 percent (1.6 to 1.7 percent) in controls (HR, 1.9; 1.8 to 2.0).
Excess risk varied by cancer type (highest for lung), was associated with cancer stage and had largely resolved by 1 year, according to researchers.