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| 1 | Evaluation of the safety and effectiveness of direct oral anticoagulants and low molecular weight heparin in gastrointestinal cancer-associated venous thromboembolism显示文摘BACKGROUND Gastrointestinal cancer(GICA)is associated with a higher incidence of venous thromboembolism(VTE)compared to other solid tumors,moreover,recurrent VTE and major bleeding(MB)complications during anticoagulation treatment have an associated increase rate.GICA-VTE remains a challenging clinical scenario with MB concerns for utilization of direct oral anticoagulants(DOAC),especially with active cancer therapies.AIM To evaluate patient risk factors,effectiveness(VTE)and safety(MB)of DOACs and low molecular weight heparin(LMWH)in patients with active GICA-VTE.METHODS A retrospective chart review of patients receiving DOACs and LMWH with GICA and symptomatic or incidental VTE treated at comprehensive cancer center from November 2013 to February 2017 was performed.Inclusion criteria included active GI cancer diagnosed at any stage or treatment+/-6 mo of VTE diagnosis,whom were prescribed 6 mo or more of DOACs or LMWH.The Chi-squared test was used for overall and the Fisher exact test for pairwise comparisons of the proportions of patients experiencing recurrent VTE and MB events.Odds ratios were used to compare the relative odds of the occurrence of the outcome given exposure to the risk factor.RESULTS A total of 144 patients were prescribed anticoagulation,in which 106 fulfilled inclusion criteria apixaban(27.3%),rivaroxaban(34.9%)and enoxaparin(37.7%),and 38 were excluded.Patients median age was 66.5 years at GICA diagnosis and 67 years at CAVTE event,with 62%males,80%Caucasian,70%stage IV,pancreatic cancer(40.5%),30%Khorana Score(≥3 points),and 43.5%on active chemotherapy.Sixty-four percent of patients completed anticoagulation therapy(range 1 to 43 mo).Recurrent VTE at 6 mo was noted in 7.5%(n=3),6.8%(n=2)and 2.7%(n=1)of patients on enoxaparin,apixaban and rivaroxaban,respectively(all P=NS).MB at 6 mo were 5%(n=2)for enoxaparin,6.8%(n=2)for apixaban and 21.6%(n=8)for rivaroxaban(overall P=0.048;vs LMWH P=0.0423;all other P=NS).Significant predictors of a primary or secondary outcome for all anticoagulation therapies included:Active systemic treatment(OR=5.1,95%CI:1.3-19.3),high Khorana Score[≥3 points](OR=5.5,95%CI:1.7-17.1),active smoker(OR=6.7,95%CI:2.1-21.0),pancreatic cancer(OR=6.8,95%CI:1.9-23.2),and stage IV disease(OR=9.9,95%CI:1.2-79.1).CONCLUSION Rivaroxaban compared to apixaban and enoxaparin had a significantly higher risk of MB on GICA-VTE patients with equivocal efficacy. | Alejandro Recio-Boiles Sumana Veeravelli Jessica Vondrak Hani M Babiker Aaron J Scott Rachna T Shroff Hitendra Patel Emad Elquza Ali McBride | 2019 | World Journal of Gastrointestinal Oncology2019，11，10： | 3 |
| 2 | Abnormal High-Density Lipoprotein Induces Endothelial Dysfunction via Activation of Toll-Like Receptor-2显示文摘 | Thimoteus Speer Lucia Rohrer Przemyslaw Blyszczuk Rukshana Shroff Kira Kuschnerus Nicolle Kr?nkel Gabriela Kania Stephen Zewinger Alexander Akhmedov Yi Shi Tina Martin Damir Perisa Stephan Winnik Maja F. Müller Urban Sester Gabriel Wernicke Andreas Jung U | 2013 | Immunity2013，，： | 2 |
| 3 | The clinical features,MRI findings,and outcome of optic neuritis in children显示文摘 | Wilejto M Shroff M Buncic JR | | 0，，02： | 1 |
| 4 | A retrospective analysis of spontaneous sphenoid sinus fistula: MR and CT findings 显示文摘 | SHETTY P G SHROFF M M FATTERPEKAR G M | 2000 | AJNR Am J Neuroradiol2000，21，： | 1 |
| 5 | A utility-based power-control scheme in wireless cellular systems显示文摘 | Xiao M Shroff N B Edwin K P | 2003 | IEEE/ACM Trans Networking2003，11，2： | 1 |
| 6 | Young obese women with poiycystic ovary syndrome have evidence of early coronary atherosclero- sis 显示文摘 | Shroff R Kerchner A Maifeld M | 2007 | J Clin Endocrinol Metab2007，92，12： | 1 |
| 7 | The clinical features, MR/ findings, and outcome of optic neuritis in children显示文摘 | Wilejto M Shroff M Buncic JR | 2006 | Neurology2006，67，： | 1 |
| 8 | Local arterial re- sponses to 32P beta-emitting stents显示文摘 | John M Shroff S Farb A | 2001 | ardio- vasc Radiat Med2001，2，3： | 1 |
| 9 | Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis显示文摘 | Shroff R Kerchner A Maifeld M | 2007 | J Clin Endocrinol Metab2007，92，12： | 1 |
| 10 | A bimodal association of vita-min D levels and vascular disease in children on dialysis显示文摘 | Shroff R Egerton M Bridel M ei al | 2008 | J AmSoc Nephrol2008，19，6： | 1 |
| 11 | Complications of transradial catheterization显示文摘 | Dandekar V K Vidovich M I Shroff A R | 2012 | Cardiovasc Revasc Med2012，13，1： | 1 |
| 12 | Activation of precipitated iron Fischer- Tropsch synthesis catalysts显示文摘 | Shroff M D Kalakkad 0 S Coulter K E | 1995 | Journal of Catalysis1995，156，2： | 1 |
| 13 | CT and MR imaging findings associated with subacute thyroiditis显示文摘 | Jhaveri K Shroff M Fatterpekar GM | 2003 | AJNR Am J Neuroradiol2003，24，1： | 1 |
| 14 | Correlation of blown film optical properties with resin properties 显示文摘 | PUCCI M S SHROFF R N | 1986 | Polym Eng Sci1986，26，8： | 1 |
| 15 | The perspectives of educators, regu- lators and funders of massage therapy on the state of the profession in British Columbia, Canada显示文摘 | Farah M Shroff Inderjeet S Sahota | 2013 | Chiropractic & Manual Therapies2013，21，1： | 1 |
| 16 | Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome 显示文摘 | Kirton A Shroff M Visvanathan T | 2007 | Stroke2007，38，： | 1 |
| 17 | Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatrophy 显示文摘 | Ozelame RV Shroff M Wood B | 2006 | Pediatr Radiol2006，36，： | 1 |
| 18 | Activation of precipitated iron Fischer-Tropsch synthesis catalysts 显示文摘 | SHROFF M D KALAKKAD D S COULTER K E | 1995 | J Catal1995，156，2： | 1 |
| 19 | Basal ganglia germinoma in children with associated ipsilateral cerebral and brain stem hemiatro- phy 显示文摘 | Ozelame RV Shroff M Wood B | 2006 | Pediatr Radiol2006，36，4： | 1 |
| 20 | Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome 显示文摘 | Kirton A Shroff M Visvanathan T | 2007 | Stroke2007，38，3： | 1 |
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