Using a thrombodynamics test for diagnostics of hypercoagulation and prediction of thromboembolic complications in patients with malignant tumors

Introduction. Venous thromboembolism complications (VTE) are prevalent severe complications observed in patients with malignant tumors. The low sensitivity and specifi city of modern scores in diagnosing VTE in these patients underscores the need to search for more effective methods of VTE diagnosis and prediction.

Aim: to assess the effi ciency of the thrombodynamics test in diagnosing hypercoagulation and prevention of VTE in patients with malignant tumors.

Materials and methods. The interim analysis included 269 patients with solid malignant tumors. The observation median value was 4.3 months. Blood tests for thrombodynamics were conducted using a thrombodynamics analyzer (HemaCore, Russia).

Results. The state of hemostatic system of this group of patients was characterized by the presence of pronounced hypercoagulation in 90 % of patients: parameter V (blood clot growth rate) > 29 μm/min in 90 % of patients. Once the antineoplastic therapy was initiated, hypercoagulation tended to decrease: median value V at the fi rst chemotherapy course was 59.9 μm/min, while median value V 3 months into chemotherapy was 56.2 μm/min (p < 0.05). With an observation median value of 4.3 months, hypercoagulation resulted in VTE complications in 14 % of patients. The Khorana score points were not reliable VTE predictors. ROC analysis of the thrombodynamics data showed that the parameter value of V higher than 40.7 μm/min was an accurate predictor of a thromboembolic event with sensitivity of 60 % and specifi city of 78 %. A relative risk of thrombosis calculated using this cut-off value was 2.7 (95 % confi dence interval 1.6–4.7; p < 0.001).

Conclusion. Thrombodynamics is a promising method for predicting VTE complications in patients with malignant tumors. This method has exhibited higher sensitivity and nearly comparable specifi city when contrasted with the Khorana score. Using this test in clinical practice facilitates the identifi cation of a group of patients who have a high risk of VTE complications and are in need of a preventive anticoagulant therapy while their Khorana score points are not elevated.

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