Key result
Switching from apixaban to low molecular weight heparin resulted in complete resolution of non-bacterial thrombotic endocarditis vegetations in a patient with metastatic lung adenocarcinoma.
Why the study?
Does LMWH resolve non-bacterial thrombotic endocarditis in a patient with malignancy who failed apixaban?
Case Report (n=1)
Does LMWH resolve non-bacterial thrombotic endocarditis in a patient with malignancy who failed apixaban?
LMWH remains the preferred anticoagulation agent over DOACs like apixaban for the treatment of non-bacterial thrombotic endocarditis associated with malignancy.
An elderly female with metastatic adenocarcinoma of the lung and atrial fibrillation presented with multiple embolic strokes while on anticoagulation with Apixaban. After further investigation, a TEE showed lesions of non-bacterial thrombotic endocarditis on the mitral valve. A decision to switch the patient to LMWH for anticoagulation was then made and a follow-up TEE showed resolution of the NBTE. In this abstract, we show that heparin should remain as the anticoagulation agent of choice in the setting of NBTE associated with malignancy.
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Akiki et al. (2023) conducted a case report in Non-bacterial thrombotic endocarditis (NBTE) (n=1). Low molecular weight heparin (enoxaparin) vs. Apixaban (prior treatment) was evaluated on Resolution of NBTE vegetation on transesophageal echocardiogram. Switching from apixaban to low molecular weight heparin resulted in complete resolution of non-bacterial thrombotic endocarditis vegetations in a patient with metastatic lung adenocarcinoma.
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