{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:43:13Z","timestamp":1792719793340,"version":"4.5.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TH Open"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Patients with pancreatic cancer are at high risk of developing venous thromboembolism (VTE). It is unknown if aspirin reduces the risk of VTE in this setting.<\/jats:p><jats:p>\n          Objectives\u2003We sought to determine whether there is an association between aspirin use and VTE risk in patients with pancreatic cancer receiving chemotherapy with a central venous catheter (CVC).<\/jats:p><jats:p>\n          Patients\/Methods\u2003We conducted a single-center, retrospective cohort study of adult patients diagnosed with pancreatic cancer and treated with chemotherapy using a CVC. Subjects were excluded if they were on anticoagulation at the time of CVC placement. The probability of VTE was analyzed using a time-to-event analysis framework for the development of VTE using the product-limit method of Kaplan and Meier (univariate) and adjusting for important confounding covariates using Cox proportional hazards regression (cause-specific hazard) and again using Fine and Gray regression (subdistributional hazard) with death prior to VTE considered a competing event.<\/jats:p><jats:p>\n          Results\u2003The final analysis included 314 cases (125 with any aspirin use and 189 without). Patients with any aspirin use had fewer VTE events (34.4%) compared with those without aspirin use (42.3%; p\u2009=\u20090.021) by log-rank test and after adjustment for multiple covariates using a Cox proportional hazards model (hazard ratio [HR]\u2009=\u20090.60; 95% confidence interval [CI]: 0.40\u20130.92; p\u2009=\u20090.019). Using Fine and Gray regression to account for death as a competing event, the effect of aspirin remained in the direction of benefit, but was not statistically significant (HR\u2009=\u20090.70; 95% CI: 0.47\u20131.05, p\u2009=\u20090.083). Higher body mass index, active smoking, and metastatic stage of cancer were associated with VTE events in the Cox proportional hazards model. Rates of major bleeding or clinically relevant minor bleeding were similar between treatment groups.<\/jats:p><jats:p>\n          Conclusions\u2003Aspirin may reduce the risk of VTE in patients with pancreatic cancer with a CVC. We did not observe a significant increase in the rates of major bleeding or clinically relevant nonmajor bleeding.<\/jats:p>","DOI":"10.1055\/s-0042-1747685","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T23:17:08Z","timestamp":1659655028000},"page":"e221-e229","source":"Crossref","is-referenced-by-count":4,"title":["Retrospective Cohort Analysis of Aspirin Use and Venous Thromboembolism in Patients with Pancreatic Cancer and an Indwelling Central Venous Catheter"],"prefix":"10.1055","volume":"06","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0519-8776","authenticated-orcid":false,"given":"Richard","family":"King","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Medical Oncology, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Medical Oncology, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Sahai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Medical Oncology, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent A.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center Biostatistics Unit, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman L.","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Medical Oncology, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.ejca.2011.10.017","article-title":"Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer","volume":"48","author":"A Maraveyas","year":"2012","journal-title":"Eur J Cancer"},{"issue":"18","key":"ref2","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1200\/JCO.2014.55.1481","article-title":"Efficacy of prophylactic low-molecular weight heparin for ambulatory patients with advanced pancreatic cancer: outcomes from the CONKO-004 Trial","volume":"33","author":"U Pelzer","year":"2015","journal-title":"J Clin Oncol"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1001\/archinte.166.4.458","article-title":"Incidence of venous thromboembolism and its effect on survival among patients with common cancers","volume":"166","author":"H K Chew","year":"2006","journal-title":"Arch Intern Med"},{"issue":"25","key":"ref4","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1056\/NEJM200012213432504","article-title":"Prognosis of cancers associated with venous thromboembolism","volume":"343","author":"H T S\u00f8rensen","year":"2000","journal-title":"N Engl J Med"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"3053","DOI":"10.1002\/cncr.26600","article-title":"Analysis of incidence and clinical outcomes in patients with thromboembolic events and invasive exocrine pancreatic cancer","volume":"118","author":"A S Epstein","year":"2012","journal-title":"Cancer"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1056\/NEJMoa1814630","article-title":"Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer","volume":"380","author":"A A Khorana","year":"2019","journal-title":"N Engl J Med"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1056\/NEJMoa1814468","article-title":"Apixaban to prevent venous thromboembolism in patients with cancer","volume":"380","author":"M Carrier","year":"2019","journal-title":"N Engl J Med"},{"issue":"17","key":"ref8","doi-asserted-by":"crossref","first-page":"6196","DOI":"10.1002\/cam4.3269","article-title":"Rivaroxaban thromboprophylaxis in ambulatory patients with pancreatic cancer: results from a pre-specified subgroup analysis of the randomized CASSINI study","volume":"9","author":"S Vadhan-Raj","year":"2020","journal-title":"Cancer Med"},{"issue":"13","key":"ref9","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1161\/CIRCULATIONAHA.114.008828","article-title":"Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration","volume":"130","author":"J Simes","year":"2014","journal-title":"Circulation"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"961","DOI":"10.2106\/JBJS.16.01253","article-title":"Venous thromboembolism following hip and knee arthroplasty: the role of aspirin","volume":"99","author":"J Parvizi","year":"2017","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1712746","article-title":"Aspirin or rivaroxaban for VTE prophylaxis after hip or knee arthroplasty","volume":"378","author":"D R Anderson","year":"2018","journal-title":"N Engl J Med"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1001\/jamainternmed.2019.6108","article-title":"Clinical effectiveness and safety of aspirin for venous thromboembolism prophylaxis after total hip and knee replacement: a systematic review and meta-analysis of randomized clinical trials","volume":"180","author":"G S Matharu","year":"2020","journal-title":"JAMA Intern Med"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e278S","DOI":"10.1378\/chest.11-2404","article-title":"Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Y Falck-Ytter","year":"2012","journal-title":"Chest"},{"issue":"10","key":"ref14","first-page":"1181","article-title":"Cancer-associated venous thromboembolic disease, version 2.2021, NCCN clinical practice guidelines in oncology","volume":"19","author":"M B Streiff","year":"2021","journal-title":"J Natl Compr Canc Netw"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer","volume":"5","author":"G H Lyman","year":"2021","journal-title":"Blood Adv"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1200\/JCO.19.01461","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update","volume":"38","author":"N S Key","year":"2020","journal-title":"J Clin Oncol"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1111\/jth.14564","article-title":"The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients: guidance from the SSC of the ISTH","volume":"17","author":"T-F Wang","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"11","key":"ref18","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1111\/jth.13140","article-title":"Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH","volume":"13","author":"S Kaatz","year":"2015","journal-title":"J Thromb Haemost"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"M E Charlson","year":"1987","journal-title":"J Chronic Dis"},{"issue":"10","key":"ref20","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1182\/blood-2007-10-116327","article-title":"Development and validation of a predictive model for chemotherapy-associated thrombosis","volume":"111","author":"A A Khorana","year":"2008","journal-title":"Blood"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1093\/biomet\/80.3.557","article-title":"Checking the Cox model with cumulative sums of martingale-based residuals","volume":"80","author":"D Y Lin","year":"1993","journal-title":"Biometrika"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.pmedr.2016.12.023","article-title":"Recent trends in the prevalence of low-dose aspirin use for primary and secondary prevention of cardiovascular disease in the United States, 2012-2015","volume":"5","author":"M Stuntz","year":"2016","journal-title":"Prev Med Rep"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1177\/1074248420925021","article-title":"Aspirin is associated with reduced rates of venous thromboembolism in older patients with cancer","volume":"25","author":"P Li","year":"2020","journal-title":"J Cardiovasc Pharmacol Ther"}],"container-title":["TH Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1747685.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T23:17:26Z","timestamp":1659655046000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1747685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":23,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,7,11]]},"published-print":{"date-parts":[[2022,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1747685","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2512-9465"],"issn-type":[{"value":"2512-9465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}