Predictive value of HDL cholesterol for cancer‐associated venous thromboembolism during chemotherapy. (17th October 2014)

• Record Type: Journal Article
• Authors: Ferroni, P.; Roselli, M.; Riondino, S.; Guadagni, F.
• Is Part Of: Journal of thrombosis and haemostasis. Volume 12:Number 12(2014:Dec.)
• Page Start: 2049
• Page End: 2053
• Publication Date: 2014-10-17
• Subjects: Thrombosis -- Periodicals; Hemostasis -- Periodicals; Blood coagulation disorders -- Periodicals; 616.1
• DOI: 10.1111/jth.12737
• Languages: English
• ISSNs: 1538-7933

Abstract

<abstract abstract-type="main" id="jth12737-abs-0001"> <title>Summary</title> <sec id="jth12737-sec-0001" sec-type="section"> <title>Background</title> <p>Dyslipidemia is a well‐known risk factor for the development of atherothrombosis; however, its involvement in venous thromboembolism (VTE) is still debated. Low levels of HDL cholesterol (HDL‐C) have been found to be associated with VTE, which is a common complication of cancer and its treatment. VTE incidence is increased in cancer patients, especially those undergoing chemotherapy.</p> </sec> <sec id="jth12737-sec-0002" sec-type="section"> <title>Objective</title> <p>We sought to investigate the value of pretreatment HDL‐C in the risk prediction of future VTE in a population of ambulatory cancer patients undergoing chemotherapy.</p> </sec> <sec id="jth12737-sec-0003" sec-type="section"> <title>Patients and Methods</title> <p>Blood lipid composition was retrospectively evaluated in 592 consecutive patients with primary (<italic>n</italic> = 373) or relapsing/recurrent (<italic>n</italic> = 219) solid cancers at the start of a new chemotherapy regimen (12% neoadjuvant, 31% adjuvant, 57% metastatic).</p> </sec> <sec id="jth12737-sec-0004" sec-type="section"> <title>Results</title> <p>VTE occurred during chemotherapy in 38 patients (median time‐to‐event: 3 months). Mean HDL‐C levels were lower in patients who developed VTE during chemotherapy (41 mg dL<sup>−1</sup>; standard deviation [SD] 13 mg dL<sup>−1</sup>) than in those who did not (48 mg dL<sup>−1</sup>; SD 14 mg dL<sup>−1</sup>). Cox proportional hazard survival analysis showed that HDL‐C levels ≤ 43 mg dL<sup>−1</sup> were able to significantly predict a first VTE episode, with a hazard ratio of 2.87 (95% confidence interval 1.45–5.68). Moreover, patients with HDL‐C levels ≤ 43 mg dL<sup>−1</sup> had worse 1‐year VTE‐free survival (86%) than those with HDL‐C levels > 43 mg dL<sup>−1</sup> (96%; log rank test, 3.14).</p> </sec> <sec id="jth12737-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Patients with low HDL‐C levels have a three‐fold higher risk of developing a first VTE episode during chemotherapy. Baseline analysis of HDL‐C levels might be of clinical value in predicting VTE in cancer outpatients treated with anticancer drugs.</p> </sec> </abstract>