OC02 | INCIDENCE AND PREDICTORS OF ARTERIAL THROMBOSIS IN CANCER PATIENTS: RESULTS FROM THE PROSPECTIVE COMPASS-ARTERIAL CANCER ASSOCIATED THROMBOSIS (COMPASS-ARTECAT) STUDY

M. Drakopoulou¹, I. Diamandoulaki², P. Baglaridis¹, P. Las Casa³, P. Van Dreden⁴, K. Toutouzas¹, G. Gerotziafas^4|5 | ¹First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece; ²Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece; ³Sorbonne University, INSERM UMR_S_938, CRSA, Research Department "Cancer, Vessels, Biology and Therapeutics" (CaVITE), Research Group "Cancer-Angiogenesis-Thrombosis and Haemostasis," Thrombosis Center, University Institute of Cancerology (UIC), Saint Antoine University Hospital Assistance Publique Hôpitaux de Paris (AP-HP) Paris France; ⁴Diagnostica Stago, clinical research, Gennevilliers, France; ⁵Center of Translational Research and Education, Department of Pathology and Laboratory Medicine, Loyola University Stritch School of Medicine, Maywood, Ill., USA

Introduction. While cancer-associated venous thromboembolism is well characterized, arterial cancer-associated thrombosis (ARTECAT) remains under-recognized. Prospective data on the incidence, timing, and predictors of ARTECAT in patients with cancer are limited

Aim. We aimed to assess the burden of ARTECAT and to identify clinical and biological predictors in a real-world cancer population.
Materials and Methods. The COMPASS-Arterial Cancer Associated Thrombosis (COMPASS-ARTeCAT) study was a multicenter, prospective, non-interventional cohort study enrolling ambulatory adults with solid tumors or selected hematological malignancies receiving or scheduled to receive systemic anticancer therapy. Patients with recent venous or arterial thrombosis or ongoing anticoagulation were excluded. Participants were followed for 12 months for the occurrence of symptomatic ARTECAT, including acute coronary syndromes, ischemic stroke or transient ischemic attack, and other systemic arterial embolic events. Cumulative incidence of ATE was estimated, and potential clinical, oncologic, and laboratory predictors were evaluated.

Results. Among 1064 enrolled patients (median age 65 years; 60% male), 72% had advanced or metastatic disease. During 12 months of follow-up, 85 patients (7.98%) experienced at least one arterial thrombotic event (ATE). The cumulative incidence of ATE was 4.47% (95% CI 3.34–5.84) at 3 months, 5.90% (95% CI 4.59–7.44) at 6 months, and 7.68% (95% CI 6.17–9.41) at 12 months, with more than half of the events happening in the first 3 months after the study started. Non-ST-elevation myocardial infarction and ischemic stroke were the most frequent early manifestations. ATE occurred more commonly in patients with lung cancer, advanced or metastatic disease, active smoking, obesity, hypertension, and renal impairment, as well as in those receiving anti-angiogenic agents or erythropoietin. Occurrence of ATE was associated with significantly reduced overall survival, whereas bleeding events were infrequent.

Conclusions. Arterial thrombosis is a frequent, early, and clinically severe complication in patients with cancer, particularly among those with lung cancer, advanced disease, and cardiovascular risk factors. These findings emphasize the necessity of dedicated arterial risk assessment and targeted prevention strategies in oncology practice.