Risk of Arterial Thromboembolism in Japanese Patients With Cancer

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In a Japanese retrospective study reported in JACC:CardioOncology, Gon et al identified the incidence and outcomes of arterial thromboembolism in patients with cancer.

Study Details

The study used data on 97,448 patients with cancer (median age = 70 years) from the Osaka Cancer Registry linked with administrative data from 2010 to 2015. Patients were monitored for 5 years after cancer diagnosis. Incidence of arterial thromboembolism was ascertained. Restricted mean survival time was used to evaluate whether antithrombotic therapy after arterial thromboembolism was associated with improved survival.

Key Findings

A total of 2,159 patients developed arterial thromboembolism. The cumulative incidence of arterial thromboembolism peaked at 1 year after cancer diagnosis at 1.29%, followed by 1.77%, 2.05%, 2.22%, and 2.32%, at 2, 3, 4, and 5 years, respectively.  

In adjusted analysis, an increased risk of arterial thromboembolism was observed among males (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.13–1.38) and patients with advanced age (HRs = 1.67, 95% CI = 1.47–1.90 for those aged ≥ 65 to > 75 years and 1.89, 95% CI = 1.66–2.16 for those aged ≥ 75 years vs < 65 years), as well as among those with an advanced disease stage and hematologic malignancies. In the first year after cancer diagnosis, the highest cumulative incidence of arterial thromboembolism was found in those with pancreatic cancer (2.1%), brain tumors (2.0%), bladder cancer (2.0%), lung cancer (1.9%), and hematologic malignancies (1.8%). At 5 years, the highest cumulative incidence was found in those with bladder cancer (3.4%), hematologic malignancies (3.1%), lung cancer (3.1%), pancreatic cancer (3.1%), and brain tumors (2.8%).

In adjusted analysis, patients with arterial thromboembolism had significantly increased risk mortality vs those without arterial thromboembolism (HR = 2.02, 95% CI = 1.86–2.20, P < .001).

For patients who received antithrombotic therapy after arterial thromboembolism vs those who did not, 90-day and 1-year restricted mean survival time differences were +13.3 days (95% CI = 10.4–16.2 days, P < .001) and +57.8 days (95% CI = 43.1–72.5 days, P < .001), respectively.

The investigators concluded, “The risk for arterial thromboembolism varies according to sex, age, and cancer progression and type. Antithrombotic therapy after arterial thromboembolism is associated with improved survival among patients with cancer.”

Yasufumi Gon, MD, PhD, of the Department of Neurology, Osaka University Graduate School of Medicine, is the corresponding author for the JACC:CardioOncology article.

Disclosure: The study was supported by the Japan Society for the Promotion of Science. For full disclosures of the study authors, visit

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