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Non-bacterial Thrombotic Endocarditis in Lung Cancer: A Systematic Review
Maikel Kamel1, Fahad Hussain1, Christian Leung1
1Department of Medicine, North Shore University Hospital, Manhasset, NY, 11030, United States.
Current Cardiology Reviews
|February 14, 2025
Summary
Nonbacterial thrombotic endocarditis (NBTE) is a rare heart valve condition often linked to lung cancer (LC). Early NBTE suspicion in LC patients with clots may improve outcomes, despite a high mortality rate.
Area of Science:
- Cardiology
- Oncology
- Thromboembolic Disease
Background:
- Nonbacterial thrombotic endocarditis (NBTE) involves aseptic vegetations on heart valves, leading to dysfunction and infarction.
- Lung cancer (LC) is a frequent malignancy associated with NBTE.
- NBTE predisposes patients to significant end-organ damage.
Approach:
- A systematic literature search of PubMed/MEDLINE was conducted from database inception to January 2024.
- Studies included patients diagnosed with both NBTE and lung cancer.
- Risk of bias was assessed using Mixed Methods Analysis Testing (MMAT).
Key Points:
- 32 patients from 31 publications were analyzed, with a mean age of 59.
- Stroke was the most common presenting symptom (47%), affecting the aortic valve (51%) most frequently.
- 86% of patients had stage IV lung cancer at NBTE diagnosis, and 61% experienced multi-organ infarcts.
- Mortality was high (77%), but chemotherapy showed a survival benefit (38% vs. 91% without).
- Low molecular weight heparin (LMWH) demonstrated a lower mortality rate (20%) compared to other anticoagulants.
Conclusions:
- High clinical suspicion for NBTE in lung cancer patients with thromboembolic events is crucial.
- Prompt diagnosis and appropriate treatment of NBTE can potentially alter clinical trajectories.
- Further research into optimal management strategies for NBTE in lung cancer patients is warranted.
Keywords:
Non-bacterial thrombotic endocarditis (NBTE)anticoagulationhypercoagulable statelung cancermalignancyvalvular vegetationsMore Related Videos
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