Contact system and intrinsic pathway activation in patients with advanced pancreatic cancer: a prospective cohort study.
J Thromb Haemost
; 21(10): 2863-2872, 2023 10.
Article
in En
| MEDLINE
| ID: mdl-37331518
ABSTRACT
BACKGROUND:
Despite high risk of venous thromboembolism (VTE) in patients with pancreatic cancer, there are little data on contact system activation in these patients.OBJECTIVES:
To quantify contact system and intrinsic pathway activation and subsequent VTE risk in patients with pancreatic cancer.METHODS:
Patients with advanced pancreatic cancer were compared with controls. Blood was drawn at baseline and patients were followed for 6 months. Complexes of proteases with their natural inhibitors, C1-esterase inhibitor (C1-INH), antithrombin (AT), or alpha-1 antitrypsin (α1at), were measured for complexes containing kallikrein (PKaC1-INH), factor (F)XIIa (FXIIaC1-INH), and FXIa (FXIaC1-INH, FXIaAT, FXIaα1at). The association of cancer with complex levels was assessed in a linear regression model, adjusted for age, sex, and body mass index. In a competing risk regression model, we assessed associations between complex levels and VTE.RESULTS:
One hundred nine patients with pancreatic cancer and 22 controls were included. The mean age was 66 years (SD, 8.4) in the cancer cohort and 52 years (SD, 10.1) in controls. In the cancer cohort, 18 (16.7%) patients developed VTE during follow-up. In the multivariable regression model, pancreatic cancer was associated with increased complexes of PKaC1-INH (P < .001), FXIaC1-INH (P < .001), and FXIaAT (P < .001). High FXIaα1at (subdistribution hazard ratio, 1.48 per log increase; 95% CI, 1.02-2.16) and FXIaAT (subdistribution hazard ratio, 2.78 highest vs lower quartiles; 95% CI, 1.10-7.00) were associated with VTE.CONCLUSION:
Complexes of proteases with their natural inhibitors were elevated in patients with cancer. These data suggest that the contact system and intrinsic pathway activation are increased in patients with pancreatic cancer.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Neoplasms
/
Venous Thromboembolism
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Thromb Haemost
Journal subject:
HEMATOLOGIA
Year:
2023
Document type:
Article