Laboratory markers for the risk of pulmonary embolism development in patients with malignant neoplasms

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Abstract

Cancer-associated thrombosis affects the course, progression, and mortality of oncologic patients. Prognostication of thromboembolism probability in patients with malignant neoplasms (MN) remains to be a quite complicated task. Previously, we published the first results of a study that identified the most significant predictors of the risk of venous thromboembolic complications (VTEC) in malignant neoplasms patients that fit the criteria of the Khorana scale, and proved the role of D-dimer and sP-selectin in the development of cancer-associated thrombosis. In continuation of the work, we performed a search for risk factors of pulmonary embolism (PE) development in MN patients from the moderate-risk VTEC group to find further management tactics for this category of patients.

The aim: to study laboratory markers of the risk of developing PE in patients with malignant neoplasms from the group of moderate risk of developing VTEC in order to improve VTEC prognostication.

Material and methods. A cohort study with a prospective cohort was performed. In the course of this study, the data of laboratory assessments were evaluated: D-dimer, sP-selectin and their combined use in outpatients with malignant neoplasms from the group of moderate risk of VTEC developing.

Results. The study revealed threshold levels of D-dimer and sP-selectin as predictors of the development of PE in patients with malignant neoplasms. With a combined excess of the threshold value of D-dimer (>1,73 μg/ml) and sP-selectin (>309,4 ng/ml), the incidence of PE in MN patients from the moderate risk group according to Khorana scale increases to 95,1% (px2 <0,001; RR 2,72; CI: 2,14–3,46).

Conclusion. Obtained results allow us to improve patient stratification by including biomarkers in multivariate predictive models for personalized VTEC risk assessment, which will contribute to the decision to start anticoagulant therapy of MN patients from the moderate risk group according to the Khorana scale.

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About the authors

Olga V. Dimitrieva

I.N. Ulyanov Chuvash State University; Republican Cardiological Dispensary of the Ministry of Healthcare of the Chuvash Republic

Author for correspondence.
Email: salgarii@mail.ru
ORCID iD: 0000-0002-7771-6141

assistant at the Department of hospital therapy, head of the Department of quality and safety control of medical activities

Russian Federation, 428015, Cheboksary, 45 Moskovsky Avenue; 428000, Cheboksary, 29A Fedora Gladkova Str.

Larisa V. Tarasova

I.N. Ulyanov Chuvash State University; Institute for Advanced Medical Education of the Ministry of Healthcare of the Chuvash Republic; Republican Clinical Hospital of the Ministry of Healthcare of the Chuvash Republic

Email: tlarisagast18@mail.ru
ORCID iD: 0000-0003-1496-0689

MD, head of the Department of hospital therapy, professor of the Department of public health and healthcare

Russian Federation, 428015, Cheboksary, 45 Moskovsky Avenue; Cheboksary; Cheboksary

Vadim E. Babokin

I.N. Ulyanov Chuvash State University; Republican Cardiological Dispensary of the Ministry of Healthcare of the Chuvash Republic; Institute for Advanced Medical Education of the Ministry of Healthcare of the Chuvash Republic

Email: babokin@bk.ru
ORCID iD: 0000-0002-2788-8762

MD, head of the Department of surgical diseases, professor of the Department of surgery, chief physician of Republican Cardiological Dispensary

Russian Federation, 428015, Cheboksary, 45 Moskovsky Avenue; 428000, Cheboksary, 29A Fedora Gladkova Str.; Cheboksary

Nikolay A. Trofimov

I.N. Ulyanov Chuvash State University; Republican Cardiological Dispensary of the Ministry of Healthcare of the Chuvash Republic; Institute for Advanced Medical Education of the Ministry of Healthcare of the Chuvash Republic; Federal Center for Traumatology, Orthopedics and Endoprosthetics of the Ministry of Healthcare of Russia; Privolzhsky Research Medical University of the Ministry of Healthcare of Russia

Email: nikolai.trofimov@mail.ru
ORCID iD: 0000-0002-1975-5521

MD., associate professor of the Department of surgical diseases and general surgery, professor of the Department of surgery, deputy chief doctor for surgery of Republican Cardiological Dispensary

Russian Federation, 428015, Cheboksary, 45 Moskovsky Avenue; 428000, Cheboksary, 29A Fedora Gladkova Str.; Cheboksary; Cheboksary; Nizhny Novgorod

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