In Search of the Appropriate Anticoagulant-Associated Bleeding Risk Assessment Model for Cancer-Associated Thrombosis Patients.
Geraldine PoenouEmmanuel TolédanoHélène HelferLudovic PlaisanceFlorent HappeEdouard VersiniNevine DiabSadji DjennaouiIsabelle MahePublished in: Cancers (2022)
Patients with venous thromboembolism events (VTE) in the context of cancer should receive anticoagulants as long as the cancer is active. Therefore, a tailor-made anticoagulation strategy should rely on an individualized risk assessment model (RAM) of recurrent VTE and anticoagulant-associated bleeding. The aim of this review is to investigate the applicability of the currently available RAMs for anticoagulant-associated bleeding after VTE in the CAT population and to provide new insights on how we can succeed in developing a new anticoagulant-associated bleeding RAM for the current medical care of CAT patients. A systematic search for peer-reviewed publications was performed in PubMed. Studies, including systematic reviews, were eligible if they comprised patients with VTE and used a design for developing a prediction model, score, or other prognostic tools for anticoagulant-associated bleeding during anticoagulant treatment. Out of 15 RAMs, just the CAT-BLEED was developed for CAT patients and none of the presented RAMs developed for the VTE general population were externally validated in a population of CAT patients. The current review illustrates the limitations of the available RAMs for anticoagulant-associated bleeding in CAT patients. The development of a RAM for bleeding risk assessment in patients with CAT is warranted.
Keyphrases
- venous thromboembolism
- atrial fibrillation
- end stage renal disease
- risk assessment
- ejection fraction
- newly diagnosed
- chronic kidney disease
- direct oral anticoagulants
- prognostic factors
- squamous cell carcinoma
- randomized controlled trial
- pulmonary embolism
- heavy metals
- patient reported outcomes
- climate change
- patient reported
- replacement therapy