Venous thromboembolism risk and management in women with cancer and thrombophilia |
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| Institution: | 1. Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI;2. Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, MI;3. Division of Cardiology, Department of Medicine, Henry Ford Hospital, Detroit, MI;4. Division of Cardiology, Department of Medicine, Detroit Medical Center, Detroit, MI;1. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan;2. Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan;3. Cardiovascular Center, Kikuna Memorial Hospital, Yokohama, Japan;4. Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan;6. Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan;5. Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan;7. Department of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan;11. Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan;12. Division of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan;8. Department of Cardiology, Shin-Koga Hospital, Kurume, Japan;10. Department of Cardiovascular Medicine, Shinshu University Graduate School of Medicine, Matsumoto, Japan;9. Cardiovascular Center, Tokeidai Memorial Hospital, Sapporo, Japan;71. Division of Trans-Catheter Therapeutics, Kanazawa Medical University Hospital, Kahoku, Japan;112. Department of Cardiology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan;123. Department of Vascular Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan;84. Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan;106. Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan;95. Department of Surgery, Kasugai Municipal Hospital, Kasugai, Japan;77. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan;1111. Office of Biostatistics and Data Management, National Cerebral and Cardiovascular Center, Suita, Japan;1212. Nishinomiya Municipal Central Hospital, Nishinomiya, Japan;1. Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa;2. University of Pittsburgh School of Medicine, Pittsburgh, Pa;3. Department of Vascular Surgery, Faculty of Medicine, Assuit University, Assuit, Egypt |
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| Abstract: | Background:Venous thromboembolism (VTE) and its complications result in a high rate of morbidity and mortality.Objective:The aim of this study was to review the risk of VTE in women with cancer and other predisposing risk factors, as well as the management of these patients.Methods:Data for this review were identified by searches of MEDLINE, Current Contents, and references from relevant articles using the search terms venous thrombosis, venous thromboembolism, pulmonary embolism, anticoagulation, risk factors, cancer, thrombophilia, heparin, and warfarin. Abstracts and reports from meetings were included only when they directly related to previously published work. Only papers published in English between 1960 and 2005 were included.Results:VTE risk is increased in patients with cancer, with 15% of these patients developing VTE or disseminated intravascular coagulation. Understanding a patient's thromboembolic risk is essential because it affects the type and duration of antithrombotic therapy. The incidence of VTE is dependent on a number of factors, including tumor type, mode of treatment, surgical procedures, patient immobility, and thrombophilia. Progression and recurrence of VTE can be prevented by therapy with unfractionated or low-molecular-weight heparin (LMWH_ followed by warfarin for at least three months. In selected women with advanced cancer disease, a long-term course of LMWH in therapeutic doses is the treatment of choice.Conclusions:In women with cancer, the clinical course is often complicated by VTE episodes. The risk of VTE increases in association with either inherited or acquired thrombophilic conditions. Appropriate management of throemboembolism in women with cancer has the potential to reduce the negative clinical outcomes related to these complications. |
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