ArticleJournal of thrombosis and haemostasis : JTH2021
Overall survival with warfarin vs. low-molecular-weight heparin in cancer-associated thrombosis.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- Sex-Related Effect of Chronic Doses of Warfarin and Menadione onInternational journal of molecular sciences · 2026Article
- Comparison of anticoagulants and risk of ischemic stroke in patients with acute cancer-associated venous thromboembolism.Blood advances · 2026Article
- Comparing survival with vitamin K antagonists, low-molecular-weight heparin, and direct oral anticoagulants in patients with cancer-a systematic review and meta-analysis.Research and practice in thrombosis and haemostasis · 2026Article
- Pancreatic Cancer and Venous Thromboembolism.International journal of molecular sciences · 2024Review
- Correlation between Metabolic Parameters and Warfarin Dose in Patients with Heart Valve Replacement of Different Genotypes.Reviews in cardiovascular medicine · 2024Article
- Plasma tissue factor activity in lung cancer patients predicts venous thromboembolism and poor overall survival.Research and practice in thrombosis and haemostasis · 2024Article
- Antithrombotic utilization, adverse events, and associations with treatment outcomes in multiple myeloma: pooled analysis of three clinical trials.Therapeutic advances in medical oncology · 2024Article
- Regulation of VKORC1L1 is critical for p53-mediated tumor suppression through vitamin K metabolism.Cell metabolism · 2023Article
- Comparative Effectiveness of Anticoagulants in Patients With Cancer-Associated Thrombosis.JAMA network open · 2023Article
- Review
- The impact of warfarin on overall survival in cancer patients.Thrombosis research · 2022Review
- Survival outcomes with warfarin compared with direct oral anticoagulants in cancer-associated venous thromboembolism in the United States: A population-based cohort study.PLoS medicine · 2022Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundWhen compared with warfarin, low-molecular-weight heparin (LMWH) reduces the incidence of recurrent venous thromboembolism (VTE) in cancer. However, a survival benefit of LMWH over warfarin for the treatment of cancer-associated VTE has not been established.
methodsUsing the Surveillance, Epidemiology and End Results and Medicare linked database from 2007 through 2016, we identified Medicare beneficiaries (aged ≥66 years) who were: (1) diagnosed with primary gastric, colorectal, pancreatic, lung, ovarian, or brain cancer; (2) diagnosed with cancer-associated VTE; and (3) prescribed LMWH or warfarin within 30 days. The primary outcome was overall survival (OS). Patients were matched 1:1 using exact matching for cancer stage and propensity score matching for cancer diagnosis, age, year of VTE, and time from cancer diagnosis to index VTE. Cox proportional-hazards regression was performed to estimate hazard ratios (HR) and 95% confidence intervals (95% CI).
resultsA total of 9706 patients were included. Warfarin was associated with a significant improvement in OS compared with LMWH (median OS, 9.8 months [95% CI, 9.1-10.4] vs. 7.2 months [95% CI, 6.8-7.8]; HR, 0.86; 95% CI 0.83-0.90; p < .001). The survival advantage was most pronounced in pancreatic (HR 0.82 [95% CI, 0.74-0.90], p < .001) and gastric cancers (HR 0.82 [95% CI, 0.68-0.98], p = .03). The observed differences in survival were consistent across subgroups including cancer stage, age, comorbidity burden, and year of VTE.
conclusionsIn this population-based study, warfarin was associated with improved OS compared with LMWH for the treatment of cancer-associated VTE.
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