SMi Source Lesson Cardiovascular: Cancer VTE

  • SMi Source lesson Cardiovascular: Cancer VTE has the following microlearning topics

  • 1. Venous Thromboembolism (VTE) Overview

    2. VTE and Cancer

    3. Incidence of Cancer in VTE Patients

    4. Knowledge Check: Risk of Cancer in Patients with VTE

    5. Knowledge Check: Piccioli et al. (2004) Trial

    6. Incidence of VTE in Cancer Patients

    7. Risk Factors for Cancer-associated VTE

    8. Cancer-related Risk Factors

    9. Assessing Impact of Treatment on VTE Risk From Observational vs. Randomized Controlled Studies

    10. Knowledge Check: Incidence of Cancer-Associated VTE

    11. Knowledge Check: Newly Diagnosed Cancer Patients

    12. Mechanisms Underlying Cancer-associated VTE

    13. Knowledge Check: NETs

    14. Knowledge Check: Inflammatory Cytokines Promoting Thrombosis

    15. Risk Assessment Tools

    16. Diagnosis of Cancer-associated VTE: Wells Score

    17. Prognosis and Risk Factors of Cancer-associated VTE

    18. Knowledge Check: Khorana Risk Tool

    19. Knowledge Check: Poor Prognosis

    20. VTE Therapeutic Agents

    21. Surgery Patients

    22. Outpatients receiving chemotherapy: Agnelli et al, 2009

    23. Outpatients receiving chemotherapy: Preventive Therapy Trials

    24. Prevention of VTE Recurrence

    25. Anticoagulant Treatment and Survival

    26. Guidelines for VTE Prevention and Treatment

    27. Knowledge Check: ASCO 2013 Guidelines

    28. Knowledge Check: Secondary Prophylaxis

    29. Summary: Cancer-associated VTE

  • Lesson Cardiovascular: Cancer VTE teaches these concepts

  • Overview: Cancer VTE, Venous Thromboembolism (VTE) Overview

  • Lesson Cardiovascular: Cancer VTE addresses these key points

  • Venous Thromboembolism (VTE)

    • Deep vein thrombosis (DVT) and pulmonary embolism (PE) 
    • Prevalence- 1-3 per 1,000
    • Incidence- 1.43 per 1,000 person-years
      • DVT at 0.93 per 1,000 person-years
      • PE at 0.5 per 1,000 person-years
    • 30-day mortality rate after VTE >25%
    • 10-year recurrence rate ~30%

    VTE Risk Factors

    • Recent surgery
    • Trauma
    • Prolonged immobility
    • Venous catheters
    • Pregnancy
    • Cancer
    • Obesity


    • Anticoagulant deficiencies
    • Factor V Leiden
    • Prothrombin G20210A
    • Fibrinogen C10034T
    • Non-type O blood group
    Risk Factors
    • Oral contraceptive use
    • Factor V Leiden mutation
    • Oral contraceptive use AND factor V Leiden mutation

    Virchow’s Triad
    Three physiological changes contribute to thrombosis:

    • Blood flow
    • Blood vessel integrity
    • The blood itself

    Reduced blood flow or stasis can be caused by:

    • Surgery
    • Periods of reduced mobility
    • Long distance travel

    The circulation of microparticles acts as a primary trigger for the activation of the coagulation cascade.

    The expression of tissue factor is increased by VTE risk factors, including:

    • Surgery
    • Trauma
    • Obesity
    • Cancer
  • Lesson Cardiovascular: Cancer VTE is built from these main references. Log into SMi Source for a complete list and details.

  • Heit, J. A., Mohr, D. N., Silverstein, M. D., Petterson, T. M., O'Fallon, W. M., & Melton, L. J. (2000). Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Archives of Internal Medicine, 160(6), 761-768.

    Manly, D. A., Boles, J., & Mackman, N. (2011). Role of tissue factor in venous thrombosis. Annual review of physiology, 73, 515.

    Mohr, D. N., Silverstein, M. D., Heit, J. A., Petterson, T. M., O'Fallon, W. M., & Melton III, L. J. (2000, December). The venous stasis syndrome after deep venous thrombosis or pulmonary embolism: a population-based study. In Mayo Clinic Proceedings (Vol. 75, No. 12, pp. 1249-1256). Elsevier.

    Naess, I. A., Christiansen, S. C., Romundstad, P., Cannegieter, S. C., Rosendaal, F. R., & Hammerstrøm, J. (2007). Incidence and mortality of venous thrombosis: a population‐based study. Journal of Thrombosis and Haemostasis, 5(4), 692-699.

    Vandenbroucke, J. P., Rosing, J., Bloemenkamp, K. W., Middeldorp, S., Helmerhorst, F. M., Bouma, B. N., & Rosendaal, F. R. (2001). Oral contraceptives and the risk of venous thrombosis. New England Journal of Medicine, 344(20), 1527-1535.