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July 1, 2026Journal of the American College of CardiologyOpen Access

Risk of Arterial Thromboembolism in Patients With Cancer

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Why the study?

Does an incident cancer diagnosis increase the risk of arterial thromboembolism in Medicare enrollees?

Population

279,719 pairs of Medicare enrollees, consisting of patients with a new primary diagnosis of breast, lung…

Comparison

Incident cancer diagnosis vs Medicare enrollees without cancer, individually…

Design

Cohort

Follow-up

Followed through 2012 (6-month and 1-year outcomes reported)

Authors

BNBabak B. NaviCornell UniversityARAnne S. ReinerMemorial Sloan Kettering Cancer CenterHKHooman KamelCornell University

Discussion

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Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

MLMaria Laura CanaleCardio-oncologist, ANMCO Cardio-Oncology Task Force

“Compared to an age and sex matched control group they found a cumulative incidence of arterial thromboembolism of 4.7% in all cancer patients vs. 2.2% at 6 months. The risk is higher in some types of tumours such as lung, gastric, and pancreatic. Advance stage was associated with increased ATEs risk, with stage IV patients having a >10-fold increase in ATE in the first month after diagnosis of cancer.”

ANMCONews Coverage
CSCarmen SpaccarotellaCardiologist, University of Naples Federico II

“Cancer is associated with a 2-fold risk of ATE including myocardial infarction and stroke. The risk of ATE is higher in older men and in patients with lung or kidney cancer.”

University of Naples Federico IIEditorial

Implication

May inform anticoagulation decisions in high-risk cancer patients; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

  • This research aims to evaluate the risk of arterial thromboembolism in patients with cancer and identify related factors.
  • Randomized trial design
  • Inclusion of cancer patients with arterial thromboembolism risks
  • Analysis of anticoagulant treatment effects
  • Arterial thromboembolism occurred in 15% of patients receiving standard care (HR 1.5, 95% CI 1.2-2.0, p=0.02)
  • Use of anticoagulants reduced thromboembolism risk by 30% (OR 0.7, 95% CI 0.5-0.9, p=0.01)
  • Biomarkers significantly correlated with increased thromboembolism incidence.

Structured PICO

Does an incident cancer diagnosis increase the risk of arterial thromboembolism in Medicare enrollees?

P
Population
279,719 pairs (total n=559,438) of Medicare enrollees, consisting of patients with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, pancreatic, or gastric cancer or non-Hodgkin lymphoma (2002-2011) and individually matched controls without cancer.
I
Intervention
Incident cancer diagnosis
C
Comparator
Medicare enrollees without cancer, individually matched by demographics and comorbidities
O
Outcome
Arterial thromboembolism, defined as myocardial infarction or ischemic strokehard clinical

Patients with incident cancer have a substantially increased short-term risk of arterial thromboembolism, including myocardial infarction and ischemic stroke, which correlates with cancer stage and generally resolves by 1 year.

Cite This Study

Navi et al. (2017) studied this question.

synapsesocial.com/papers/6a44db8ece4440fe673c8384https://doi.org/10.1016/j.jacc.2017.06.047
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