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Author Spotlight: Advancing Cancer Associated Thrombosis Research in Rodent Models
Published on: January 5, 2024
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Cancer-associated Marantic Endocarditis and Direct Oral Anticoagulants: Case Report and Systematic Review.
Glaudir Donato1, Filipe Castor1, João Vitor Andrade Fernandes1
1Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil.
Current Cardiology Reviews
|August 7, 2025
Summary
Cancer-associated nonbacterial thrombotic endocarditis (NBTE) management remains challenging. While heparins show promise, further research is needed on direct oral anticoagulants (DOACs) for NBTE treatment.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Nonbacterial thrombotic endocarditis (NBTE) is characterized by sterile vegetations on heart valves, often linked to malignancy and systemic hypercoagulability.
- NBTE is frequently underdiagnosed and poses clinical challenges, commonly presenting as thromboembolic events like ischemic stroke.
Purpose of the Study:
- To report the first case of cancer-associated NBTE responding to rivaroxaban as maintenance anticoagulation, with documented vegetation reduction via 3D echocardiography.
- To systematically review the efficacy of direct oral anticoagulants (DOACs) in treating cancer-associated NBTE.
Main Methods:
- A case study combined with a systematic review of case reports on DOAC use in cancer-associated non-valvular atrial fibrillation (NVAF).
- Literature search of electronic databases, followed by qualitative data extraction and analysis of demographics, clinical presentation, therapies, and outcomes.
Main Results:
- Thirty-three studies were included. Most patients were on DOACs prior to NBTE diagnosis. Lung and pancreatic cancers were most common.
- Heparin, particularly low-molecular-weight heparin, demonstrated better outcomes in vegetation resolution and thromboembolic event prevention compared to DOACs.
- Effective NBTE management with DOACs was associated with successful control of the underlying neoplasm.
Conclusions:
- Heparins are suggested as more appropriate for treating cancer-associated NBTE.
- Further research is warranted to explore satisfactory outcomes with DOACs in NBTE management.
- Successful management of NBTE with DOACs appears contingent on effective control of the primary cancer.
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