Evidence map›Paper›PMID 39978269›Full record

ArticleThrombosis research2025

Association between anticoagulant-related bleeding and mortality in patients with hematological malignancies and cancer-associated venous thromboembolism.

Tzu-Fei Wang, Suhong Luo, Brian F Gage, Martin W Schoen, Amber Afzal, Kenneth Carson, Su-Hsin Chang, Amir Mahmoud, Kristen M Sanfilippo

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thrombosis research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tzu-Fei WangDepartment of Medicine, University of Ottawa at The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Suhong LuoSaint Louis Veterans Affairs Medical Center and Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Brian F GageDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Martin W SchoenSaint Louis Veterans Affairs Medical Center and Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Department of Medicine, St. Louis University Medical Center, St. Louis, MO, USA.
Amber AfzalDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Kenneth CarsonDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Su-Hsin ChangDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Amir MahmoudDepartment of Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Kristen M SanfilippoSaint Louis Veterans Affairs Medical Center and Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: ksanfilippo@wustl.edu.

Funding

Prediction of Anticoagulant-Related Bleeding Risk in Patients with CancerR01HL166386 · NHLBI · WASHINGTON UNIVERSITY · PI Kristen Marie Sanfilippo · 2023 to 2026
$1.6M
NHLBI NIH HHS R01 HL166386
6 · The paper itself

Abstract

introductionPatients with hematological malignancies are at an increased risk of severe bleeding. Anticoagulant (AC) therapy further increases this risk. Mortality after these bleeds is unclear and may differ by bleeding site. Aim To evaluate the association between bleeding and mortality in patients with hematological malignancies prescribed AC therapy for cancer-associated venous thromboembolism (VTE).

methodsIn a nationwide cohort of US Veterans (2012-2020), we identified patients with hematological malignancies and cancer-associated VTE prescribed AC therapy. Bleeding events were identified by a previously validated algorithm using hospitalization International Classification of Disease (ICD) codes. Within 12 months of AC therapy initiation, we evaluated the association between bleeding and mortality using multivariate Cox regression models, with AC-related bleeding analyzed as a time-varying covariate.

resultsThe cohort included 1825 patients. Within 12 months of starting AC therapy, 123 (6.7 %) had bleeding events and 162 (8.9 %) patients died. Patients with bleeding events were more likely to have anemia, history of bleeding, aspirin use, chemotherapy use, and frailty. A multivariable Cox proportional-hazard model showed that AC-related bleeding was associated with tripled mortality rate (aHR 3.26, 95 % CI 1.96-5.45). When stratified by bleeding site, intracranial bleeding was associated with the highest risk of death (aHR 13.41, 95 % CI 4.13-43.48), followed by gastrointestinal bleeding (aHR 4.55, 95 % CI 2.48-8.35).

conclusionIn this cohort of patients with hematological malignancies and newly diagnosed VTE initiated on AC therapy, bleeding was associated with an increased risk of mortality within 12 months. Association was highest with intracranial and gastrointestinal bleeding.

Indexed as

AnticoagulantsHematologic NeoplasmsHemorrhageVenous ThromboembolismAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedRisk FactorsAnticoagulantsAnticoagulationBleedingcancer-associated thrombosisHemorrhageMortalityVenous thromboembolism

Identifiers

PMID39978269
PMCPMC12060022

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.