Unusual rapid progression of non-bacterial thrombotic endocarditis in a patient with bladder cancer despite undergoing intensification treatment with rivaroxaban for acute venous thromboembolism

Fujimoto, Daichi; Mochizuki, Yasuhide; Nakagiri, Keitaro; Shite, Junya

doi:10.1093/eurheartj/ehy569

Cited by 7 publications

(2 citation statements)

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“…Among 829 searched studies, 121 studies [ 19 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ...…”

Section: Resultsunclassified

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Rahouma

Khairallah

Dabsha

et al. 2023

Cancers

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Hypercoagulability is strongly associated with cancer and may result in non-bacterial thrombotic endocarditis (NBTE). The aim of our meta-analysis was to explore the demographics and characteristics of this condition in cancer. Databases were systematically searched. The outcomes were to identify the annual trend in premortem diagnosis among the entire cohort and different subgroups and to identify differences in characteristics and survival in the considered population. A total of 121 studies with 144 patients were included. The proportion of marantic endocarditis associated with lung cancer was 0.29 (95% CI, 0.21–0.37; p < 0.001), that associated with pancreatic cancer was 0.19 (95% CI, 0.13–0.27; p < 0.001), that associated with advanced cancer stage (metastasis) was 0.69 (95% CI, 0.61–0.76; p < 0.001), and that associated with adenocarcinoma was 0.65 (95% CI, 0.56–0.72; p < 0.001). Median and 6-month overall survival (OS) were 1.3 months and 32.3%, respectively, with 6-month OS of 20.8% vs. 37.0% in lung vs. other cancers, respectively (p = 0.06) and 42.9% vs. 31.1% among those who underwent intervention vs. those who did not (p = 0.07). Cases discovered in recent years had better survival (HR = 0.98 (95% CI, 0.96–0.99; p = 0.003). While cancer-associated NBTE is a rare entity, lung cancers were the most common tumor site and are frequently associated with more advanced and metastatic cancer stages. The prognosis is dismal, especially among lung cancers.

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Section: Resultsunclassified

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Rahouma

Khairallah

Dabsha

et al. 2023

Cancers

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“…However, the efficacy of DOAC treatment for patients with NBTE remains uncertain. Some authors report that patients with NBTE who receive DOACs go on to experience arterial embolisms, including cerebral infarctions (9)(10)(11). In patients with NBTE, the most effective anticoagulant therapy is considered to be unfractionated heparin, which has been shown to reduce the incidence of recurrent thromboembolic events (12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

Treatment with a Direct Oral Anticoagulant for Nonbacterial Thrombotic Endocarditis

et al. 2021

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We herein report a case of nonbacterial thrombotic endocarditis (NBTE) in a patient with previously undiagnosed lung cancer. A 62-year-old woman presented to our hospital with multiple cerebral infarctions. There was no evidence of valvular heart disease or vegetations. Whole-leg ultrasonography revealed deep vein thrombosis of the left peroneal vein. We administered direct oral anticoagulants (DOACs) for a presumed diagnosis of paradoxical embolisms caused by patent foramen ovale. Unfortunately, she experienced further embolization and died. At a postmortem examination, she was diagnosed with NBTE and metastatic adenocarcinoma of the lung. Our experience with this patient suggests that DOACs may be an insufficient treatment for NBTE.

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Neurologic complications of nonbacterial thrombotic endocarditis

Dafer

2021

Handbook of Clinical Neurology

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Unusual rapid progression of non-bacterial thrombotic endocarditis in a patient with bladder cancer despite undergoing intensification treatment with rivaroxaban for acute venous thromboembolism

Cited by 7 publications

References 0 publications

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

Treatment with a Direct Oral Anticoagulant for Nonbacterial Thrombotic Endocarditis

Neurologic complications of nonbacterial thrombotic endocarditis

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