Faculty of Medicine

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    Predictors of active cancer thromboembolic outcomes. RIETE experience of the Khorana score in cancer-associated thrombosis.
    (Thieme, 2017)
    Tafur AJ,
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    Caprini JA,
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    Cote L
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    Trujillo-Santos J
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    Del Toro J,
    Even though the Khorana risk score (KRS) has been validated to predict against the development of VTE among patients with cancer, it has a low positive predictive value. It is also unknown whether the score predicts outcomes in patients with cancer with established VTE. We selected a cohort of patients with active cancer from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry to assess the prognostic value of the KRS at inception in predicting the likelihood of VTE recurrences, major bleeding and mortality during the course of anticoagulant therapy. We analysed 7948 consecutive patients with cancer-associated VTE. Of these, 2253 (28 %) scored 0 points, 4550 (57 %) 1-2 points and 1145 (14 %) scored ≥3 points. During the course of anticoagulation, amongst patient with low, moderate and high risk KRS, the rate of VTE recurrences was of 6.21 (95 %CI: 4.99-7.63), 11.2 (95 %CI: 9.91-12.7) and 19.4 (95 %CI: 15.4-24.1) events per 100 patient-years; the rate of major bleeding of 5.24 (95 %CI: 4.13-6.56), 10.3 (95 %CI: 9.02-11.7) and 19.4 (95 %CI: 15.4-24.1) bleeds per 100 patient-years and the mortality rate of 25.3 (95 %CI: 22.8-28.0), 58.5 (95 %CI: 55.5-61.7) and 120 (95 %CI: 110-131) deaths per 100 patient-years, respectively. The C-statistic was 0.53 (0.50-0.56) for recurrent VTE, 0.56 (95 %CI: 0.54-0.59) for major bleeding and 0.54 (95 %CI: 0.52-0.56) for death. In conclusion, most VTEs occur in patients with low or moderate risk scores. The KRS did not accurately predict VTE recurrence, major bleeding, or mortality among patients with cancer-associated thrombosis.
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    CORRELATION BETWEEN SERUM LEVEL OF PLACENTAL GROWTH FACTOR IN FIRST TRIMESTER OF PREGNANCY AND SUBSEQUENT PREECLAMPSIA DEVELOPMENT - А PILOT STUDY
    (Македонско лекарско друштво = Macedonian Medical Association, 2019)
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    Abstract Introduction. Preeclampsia (PE) is one of the leading causes for maternal and perinatal morbidity and mortality. The possibility of PE development prediction is essential for adequate management of this pathology, especially in terms of undertaken measures for disease prevention. Aim. To determine whether there is a correlation between serum levels of Placental Growth Factor (PlGF) in the first trimester of pregnancy with subsequent PE development. Methods. Study population was consisted of 307 pregnant women in the first trimester of pregnancy who had visited Special Hospital for Obstetrics and Gynecology “Mother Teresa” for aneuploidy screening. During this visit, blood was taken for measuring the PlGF level. The study was prospective-observational-cohort. All pregnant women were monitored for PE development until delivery. The group of pregnant women with PE was matched with that without disease by comparing PlGF values. Results. From the initial pool, only 283 participants completed the study. Among them, 7 developed PE. The average PlGF concentration in PE+ group was 32.29 pg/ml (1.06 MoM’s), and in PE-group 45.42 pg/ml (1.58 MoM’s). The difference between the results of the women destined to develop PE in comparison with those who are not, was statistically significant (0.018 and 0.011 for pg/ml and MoM’s respectively). Conclusion. Low serum level of PlGF in the first trimester of pregnancy is correlated with subsequent PE development.