Citro Rodolfo, Prota Costantina, Resciniti Elvira, Radano Ilaria, Posteraro Alfredo, Fava Antonella, Monte Ines Paola
Heart Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
Department of Cardiology, Maggiore Hospital, Bologna, Italy.
J Cardiovasc Echogr. 2020 Apr;30(Suppl 1):S38-S44. doi: 10.4103/jcecho.jcecho_63_19. Epub 2020 Apr 10.
Venous thromboembolism (VTE) represents a major health problem, especially in cancer patients, who experience a significantly higher incidence of both deep vein thrombosis and pulmonary embolism compared to the general population. Indeed, patients with cancer have a prothrombotic state resulting in both increased expression of procoagulants and suppression of fibrinolytic activity. In addition, VTE increases the morbidity and mortality of these patients. For all these reasons, the prevention and treatment of VTE in cancer setting represent major challenges in daily practice. In general, low-molecular-weight heparin monotherapy is the standard of care for the management of cancer-associated VTE, as Vitamin K antagonists are less effective in this setting. Direct oral anticoagulants offer a potentially promising treatment option for cancer patients with VTE, since recent studies demonstrated their efficacy and safety also in this peculiar setting.
静脉血栓栓塞症（VTE）是一个重大的健康问题，尤其是在癌症患者中，与普通人群相比，他们发生深静脉血栓形成和肺栓塞的几率要高得多。事实上，癌症患者处于血栓前状态，导致促凝血剂表达增加和纤溶活性受到抑制。此外，VTE会增加这些患者的发病率和死亡率。由于所有这些原因，癌症患者VTE的预防和治疗是日常临床实践中的重大挑战。一般来说，低分子量肝素单一疗法是治疗癌症相关VTE的标准治疗方法，因为维生素K拮抗剂在这种情况下效果较差。直接口服抗凝剂为患有VTE的癌症患者提供了一种潜在的有前景的治疗选择，因为最近的研究表明它们在这种特殊情况下也具有疗效和安全性。
