RELATIONSHIP BETWEEN ACTIVATED PROTEIN-C RESISTANCE AND CENTRAL VENOUS DEVICE-RELATED COMPLICATIONS

We studied the relationship between activated protein C (APC) resistan ce and the central venous devices (CVD)-related complications in 61 ca ncer patients (44 females and 17 males, median age 50 years, 71 CVD) f rom November 1994 to November 1995. Two patients (3.3%) had APC resist ance, i.e., APC ratio < 2. Twelve episodes of bacteremia, 8 site infec tions, 31 cases of CVD dysfunction requiring urokinase (UK), and 3 CVD -related thromboses were noted. With Cox's proportional hazard models, low APC ratios and high d-dimer levels were significantly associated with CVD-related bacteremia (p = 0.0207 and 0.0210). Such an associati on was not observed with site infection and CVD dysfunction. The incid ence of thrombosis was too low to be analyzed. However, one patient wi th APC resistance developed subclavian vein thrombosis, leading to eve ntual removal of the catheter. The prevalence of APC resistance in can cer patients and its association with bacteremia are discussed.