Evidence map›Paper›PMID 40579365›Full record

SynthesisEuropean heart journal2026

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

Faizan Khan, Tobias Tritschler, Caterina E Marx, Vincent Lanting, Bram Rochwerg, Alexandre Tran, Shannon M Fernando, Diane L Lorenzetti, Hannah Wunsch, Jessalyn Holodinsky and 12 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European heart journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. 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

22 authors.

Faizan KhanDepartment of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3330 Hospital 83 Drive NW, Calgary, Alberta, Canada T2N 4N1.ORCID 0000-0001-7570-0755
Tobias TritschlerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Caterina E MarxDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Vincent LantingDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Bram RochwergDepartments of Medicine and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Alexandre TranInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Shannon M FernandoDepartment of Critical Care, Lakeridge Health, Oshawa, Ontario, Canada.
Diane L LorenzettiDepartment of Community Health Sciences, Cumming School of Medicine and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada.
Hannah WunschDepartment of Anesthesiology, Weill Cornell Medical College, New York, NY, USA.
Jessalyn HolodinskyDepartments of Emergency Medicine, Community Health Sciences, and Clinical Neurosciences, Centre for Health Informatics, O'Brien Institute for Public Health, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Kirsten FiestDepartments of Critical Care Medicine and Community Health Sciences, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Henry Thomas StelfoxFaculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Aurélien DellucInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Dean A FergussonInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Grégoire Le GalInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Philip S WellsInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Tzu-Fei WangInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Kristen SanfilippoDepartment of Medicine, St. Louis Veterans Administration Medical Center, Washington University School of Medicine, St. Louis, MO, USA.
Nick van EsDepartment of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0001-5256-6346
Deborah SchragMemorial Sloan Kettering Cancer Center, New York, NY, USA.
Jean M ConnorsBrigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Marc CarrierInflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0001-8296-2972

Funding

Canadian Venous Thromboembolism Research NetworkCIHR CDT-142654
6 · The paper itself

Abstract

BACKGROUND AND

aimsPatients with cancer and venous thromboembolism (VTE) have a high risk of recurrent VTE and anticoagulant-related bleeding. This study aimed to identify prognostic factors for these complications.

methodsA systematic review was performed for randomized trials and cohort studies evaluating prognostic factors for recurrent VTE or anticoagulant-related bleeding in adult patients with cancer and VTE. Adjusted hazard ratios (aHRs) for factors were pooled using random-effects meta-analysis. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach.

resultsThirty-three studies (n = 96 753) were included in the meta-analyses. Factors with high certainty of association with increased risk of recurrent VTE included a previous history of VTE [aHR 1.50 (95% CI 1.08-2.09)], Eastern Cooperative Oncology Group (ECOG) performance status >0 [1.81 (1.34-2.46)] or >1 [2.44 (1.55-3.84)], advanced cancer [1.38 (1.15-1.65)], and specific cancer sites including lung [1.78 (1.29-2.46)], hepatobiliary [2.37 (1.70-3.30)], pancreas [3.20 (2.06-4.96)], and genitourinary [1.38 (1.14-1.67)]. Conversely, recent surgery [aHR 0.56 (95% CI 0.40-0.76)] and breast cancer [0.43 (0.23-0.81)] had a high certainty of association with a decreased risk. Factors with a high certainty of association with an increased risk of anticoagulant-related bleeding included a history of bleeding [aHR 2.41 (95% CI 1.50-3.88)], ECOG performance status ≥2 [2.10 (1.48-2.99)], advanced cancer [1.60 (1.29-1.97)], and cancers of the brain [2.25 (1.64-3.09)], gastrointestinal system [1.74 (1.44-2.11)], genitourinary system [1.90 (1.48-2.45)], and prostate [1.72 (1.26-2.34)].

conclusionsThe prognostic factors identified in this meta-analysis should be considered as part of risk stratification frameworks for anticoagulation management in patients with cancer and VTE.

Indexed as

AnticoagulantsHemorrhageNeoplasmsVenous ThromboembolismAdultFemaleHumansMalePrognosisRandomized Controlled Trials as TopicRecurrenceRisk FactorsAnticoagulantsBleedingCancerVenous thromboembolism

Identifiers

PMID40579365
PMCPMC13099206

What Socratic holds

Textmetadata
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 Socratic graph.