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

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.