Clinical cases and a practical approach to cancer-associated thrombosis and cardiovascular complications: risk assessment, pathophysiology, and therapeutic options

Cancer-associated thrombotic complications are common in oncological patients and often proceed with significant complications, leading to increased morbidity and mortality. They are the result of a complex interaction between tumor-specific factors, individual patient characteristics, and the type of oncological treatment. This review examines the epidemiology, risk factors, and the main pathophysiological mechanisms of cancer-associated thrombosis, and presents validated screening systems for thrombotic risk assessment such as the Khorana score and COMPASS-CAT. Contemporary strategies for primary and secondary thromboprophylaxis are discussed, including the role of low-molecular-weight heparins and direct oral anticoagulants. The review is complemented by clinical cases from our practice, illustrating the diagnostic and therapeutic challenges of cancer-associated thrombosis and its related cardiovascular complications.

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Journal
Bulgarian Cardiology
Published
2026-10-30
DOI
https://doi.org/10.3897/bgcardio.32.e186566
Primary Topic
Venous Thromboembolism Diagnosis and Management
Type
article
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article

Clinical cases and a practical approach to cancer-associated thrombosis and cardiovascular complications: risk assessment, pathophysiology, and therapeutic options

Desislava Somleva, Angelina Borizanova, Assen Goudev, Elena Kinova et al.
4 links
Bulgarian Cardiology
Venous Thromboembolism Diagnosis and Management
article

Clinical cases and a practical approach to cancer-associated thrombosis and cardiovascular complications: risk assessment, pathophysiology, and therapeutic options

Desislava Somleva, Angelina Borizanova, Assen Goudev, Elena Kinova, Bozhidar Krastev, Natalia Spasova, Petar Kalaydzhiev, D. Markov
article en

Abstract

Cancer-associated thrombotic complications are common in oncological patients and often proceed with significant complications, leading to increased morbidity and mortality. They are the result of a complex interaction between tumor-specific factors, individual patient characteristics, and the type of oncological treatment. This review examines the epidemiology, risk factors, and the main pathophysiological mechanisms of cancer-associated thrombosis, and presents validated screening systems for thrombotic risk assessment such as the Khorana score and COMPASS-CAT. Contemporary strategies for primary and secondary thromboprophylaxis are discussed, including the role of low-molecular-weight heparins and direct oral anticoagulants. The review is complemented by clinical cases from our practice, illustrating the diagnostic and therapeutic challenges of cancer-associated thrombosis and its related cardiovascular complications.

Bulgarian CardiologyVol. 32(3)
Queen Giovanna Hospital (BG), Medical University of Sofia (BG)
Good health and well-being
Openalex Percentile: Top 10%
Venous Thromboembolism Diagnosis and Management
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