Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer

Englisch, Cornelia; Königsbrügge, Oliver; Nopp, Stephan; Moik, Florian; Quehenberger, Peter; Preusser, Matthias; Pabinger, Ingrid; Ay, Cihan

doi:10.3390/ijms232415770

Open AccessArticle

Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer

by

Cornelia Englisch

¹

,

Oliver Königsbrügge

¹

,

Stephan Nopp

¹

,

Florian Moik

^1,2

,

Peter Quehenberger

³,

Matthias Preusser

⁴,

Ingrid Pabinger

¹ and

Cihan Ay

^1,*

¹

Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria

²

Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria

³

Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria

⁴

Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria

^*

Author to whom correspondence should be addressed.

Int. J. Mol. Sci. 2022, 23(24), 15770; https://doi.org/10.3390/ijms232415770

Submission received: 12 October 2022 / Revised: 24 November 2022 / Accepted: 8 December 2022 / Published: 12 December 2022

(This article belongs to the Special Issue Frontiers in Thrombosis)

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Abstract

Venous and arterial thromboembolism (VTE/ATE) are common complications in cancer patients. Antithrombin deficiency is a risk factor for thrombosis in the general population, but its connection to risk of cancer-associated thrombosis is unclear. We investigated the association of antithrombin activity levels with risk of cancer-associated VTE/ATE and all-cause mortality in an observational cohort study including patients with cancer, the Vienna Cancer and Thrombosis Study. In total, 1127 patients were included (45% female, median age: 62 years). Amongst these subjects, 110 (9.7%) patients were diagnosed with VTE, 32 (2.8%) with ATE, and 563 (49.9%) died. Antithrombin was not associated with a risk of VTE (subdistribution hazard ratio (SHR): 1.00 per 1% increase in antithrombin level; 95% CI: 0.99–1.01) or ATE (SHR: 1.00; 95% CI: 0.98–1.03). However, antithrombin showed a u-shaped association with the risk of all-cause death, i.e., patients with very low but also very high levels had poorer overall survival. In the subgroup of patients with brain tumors, higher antithrombin levels were associated with ATE risk (SHR: 1.02 per 1% increase; 95% CI: 1.00–1.04) and mortality (HR: 1.01 per 1% increase; 95% CI: 1.00–1.02). Both high and low antithrombin activity was associated with the risk of death. However, no association with cancer-associated VTE and ATE across all cancer types was found, with the exception of in brain tumors.

Keywords: antithrombin; antithrombin deficiency; cancer-associated thrombosis

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MDPI and ACS Style

Englisch, C.; Königsbrügge, O.; Nopp, S.; Moik, F.; Quehenberger, P.; Preusser, M.; Pabinger, I.; Ay, C. Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer. Int. J. Mol. Sci. 2022, 23, 15770. https://doi.org/10.3390/ijms232415770

AMA Style

Englisch C, Königsbrügge O, Nopp S, Moik F, Quehenberger P, Preusser M, Pabinger I, Ay C. Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer. International Journal of Molecular Sciences. 2022; 23(24):15770. https://doi.org/10.3390/ijms232415770

Chicago/Turabian Style

Englisch, Cornelia, Oliver Königsbrügge, Stephan Nopp, Florian Moik, Peter Quehenberger, Matthias Preusser, Ingrid Pabinger, and Cihan Ay. 2022. "Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer" International Journal of Molecular Sciences 23, no. 24: 15770. https://doi.org/10.3390/ijms232415770

APA Style

Englisch, C., Königsbrügge, O., Nopp, S., Moik, F., Quehenberger, P., Preusser, M., Pabinger, I., & Ay, C. (2022). Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer. International Journal of Molecular Sciences, 23(24), 15770. https://doi.org/10.3390/ijms232415770

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Antithrombin Activity and Association with Risk of Thrombosis and Mortality in Patients with Cancer

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