Pulmonary vascular disease & thromboembolism

Predictors of recurrent venous thromboembolism and bleeding in patients with cancer: a meta-analysis

Eur Heart JPublished Systematic review and meta-analysis of randomised trials and cohort studies

Study context

Population
Adults with cancer and venous thromboembolism (VTE)
Participants
96,753 adults · 33 studies
Outcome
Prognostic factors for recurrent VTE and anticoagulant-related bleeding (pooled adjusted hazard ratios (aHRs))
Methodological detailsrandom-effects, GRADE certainty assessment
  • Random-effects
  • GRADE certainty assessment

Pooled result

As reported in the abstract

Recurrent VTE: factors with high certainty of association
Adjusted hazard ratio (95% CI)
Previous history of VTEincreased risk
1.50(1.08–2.09)
ECOG performance status >0increased risk
1.81(1.34–2.46)
ECOG performance status >1increased risk
2.44(1.55–3.84)
Advanced cancerincreased risk
1.38(1.15–1.65)
Lung cancerincreased risk
1.78(1.29–2.46)
Hepatobiliary cancerincreased risk
2.37(1.70–3.30)
Pancreas cancerincreased risk
3.20(2.06–4.96)
Genitourinary cancerincreased risk
1.38(1.14–1.67)
Recent surgerydecreased risk
0.56(0.40–0.76)
Breast cancerdecreased risk
0.43(0.23–0.81)

Further pooled results

Anticoagulant-related bleeding: factors with high certainty of increased risk

ComparisonaHR (95% CI)
History of bleeding2.41 (1.50–3.88)
ECOG performance status ≥22.10 (1.48–2.99)
Advanced cancer1.60 (1.29–1.97)
Brain cancer2.25 (1.64–3.09)
Gastrointestinal cancer1.74 (1.44–2.11)
Genitourinary cancer1.90 (1.48–2.45)
Prostate cancer1.72 (1.26–2.34)

Original publication

Predictors of recurrent venous thromboembolism and bleeding in patients with cancer: a meta-analysis. Eur Heart J. Published 22 June 2025. doi:10.1093/eurheartj/ehaf453

Summarised from the published abstract; every number is checked against it

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