[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-349321-105":59,"doc-detail-349321-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","cancer-associated-marantic-endocarditis-and-direct-oral-anticoagulants-case-report-and-systematic-review","Cancer-associated Marantic Endocarditis and Direct Oral Anticoagulants - Case Report and Systematic Review","","Nonbacterial thrombotic endocarditis (NBTE) involves sterile heart-valve vegetations driven by systemic hypercoagulability and is often linked to malignancies, yet frequently underdiagnosed until thromboembolic complications emerge, especially ischemic stroke. The study reports the first cancer-associated NBTE case with a positive response to rivaroxaban, supported by 3D echocardiography showing vegetation reduction. A systematic review of DOAC case reports evaluates cancer-associated NBTE treatment outcomes and discusses emerging comparative effectiveness signals.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/cancer-associated-marantic-endocarditis-and-direct-oral-anticoagulants-case-report-and-systematic-review/349321/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/cancer-associated-marantic-endocarditis-and-direct-oral-anticoagulants-case-report-and-systematic-review/349321.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-26","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is cancer-associated NBTE and why is it clinically challenging?","Question",{"text":112,"@type":113},"NBTE is characterized by sterile vegetations on heart valves caused by systemic hypercoagulability, commonly associated with advanced malignancies. It is frequently underdiagnosed and often first recognized after thromboembolic events such as ischemic stroke.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the reported case show about rivaroxaban in maintaining anticoagulation?",{"text":117,"@type":113},"The case documents a positive response to rivaroxaban as maintenance anticoagulation, with 3D echocardiographic evidence of reduced valvular vegetations over follow-up.",{"name":119,"@type":110,"acceptedAnswer":120},"How did DOAC outcomes compare with heparin in the systematic review?",{"text":121,"@type":113},"Across the included case reports, many patients were already receiving DOACs before NBTE diagnosis. After diagnosis, anticoagulation often shifted from DOACs to heparin, and low-molecular-weight heparin showed better outcomes regarding vegetation resolution and prevention of thromboembolic events.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},349321,1790388946,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":36},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Send Orders for Reprints [to reprints@benthamscience.net](to reprints@benthamscience.net)  \nGlaudir Donato 1,*, Filipe Castor 1, João Vitor Andrade Fernandes 1, Emilio Carlos de Arruda Lacerda2, Ariane Vieira Scarlatelli Macedo3 and Marcelo Melo 1,4  \n1Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil; 2Department of Oncology, Napoleão Laureano Hospital, João Pessoa, Brazil; 3Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo (SP), Brazil; 4Internal Medicine Department, Federal University of Paraíba, João Pessoa, Brazil  \nCurrent Cardiology Reviews  \nAbstract: Introduction: Nonbacterial thrombotic endocarditis (NBTE) involves sterile vegetations on heart valves due to systemic hypercoagulability, often linked to malignancies. It is frequently underdiagnosed and presents significant clinical management challenges, often manifesting as thromboembolic events like ischemic stroke. We aim to report the first case of cancerassociated NBTE that showed a positive response to rivaroxaban as a maintenance anticoagulant, with 3D echocardiographic evidence of vegetation reduction, and to evaluate the performance of direct oral anticoagulants (DOACs) in treating cancer-associated NBTE through a systematic review of case reports.  \nMethods: A case study and a systematic review of case reports on the use of DOACs in the setting of cancer-associated non-valvular atrial fibrillation were presented. Electronic databases were searched, and relevant studies were selected based on predefined eligibility criteria. Data were extracted and analyzed qualitatively, focusing on demographics, clinical presentation, anticoagulation and anticancer therapies, and outcomes (surgery, NBTE resolution, thromboembolicevents, and mortality) .  \nResults and Discussion: In addition to our case, thirty-three studies were included in the systematic review. Most patients were already on DOAC therapy before the NBTE diagnosis. Lung and pancreatic cancers were the most common primary neoplasms. The aortic and mitral valves were most frequently affected. Anticoagulation therapy often shifted from DOACs to heparin upon NBTE diagnosis, with low-molecular-weight heparin showing better outcomes in vegetation resolution and thromboembolic event prevention.  \nDiscussion: This study reinforces the suggestion that heparins are more appropriate for treating cancer-associated NBTE. However, satisfactory DOAC outcomes warrant further research. Conclusion: Effective NBTE management with DOACs appears to be strongly associated with the successful control of the underlying neoplasm.  \nKeywords: Non-infective endocarditis, neoplasms, anticoagulants, transesophageal echocardiography, three-dimensional echocardiography, marantic endocarditis.  \n1. INTRODUCTION  \nNonbacterial thrombotic endocarditis (NBTE), also known as Marantic endocarditis or non-infective endocarditis, was first described in 1888 by Ziegler, who initially termed it thromboendocarditis [1] . It involves the formation of sterile vegetations on previously healthy heart valves,  \n*Address correspondence to this author at the Center of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil. Cidade Universitária, s/n  \n- Conj. Pres. Castelo Branco III, 58051-900, João Pessoa, Paraíba, Brazil; [E-mail. glaudirjunior@icloud.com](E-mail. glaudirjunior@icloud.com)  \nresulting from a state of systemic hypercoagulability [2, 3] . This pathology is associated with underlying clinical conditions, notably advanced neoplasms, followed by autoimmune diseases such as antiphospholipid syndrome, systemic lupus erythematosus, and rheumatoid arthritis [4-7] .  \nIn addition to being frequently underdiagnosed and often only detected post-mortem, NBTE poses challenges for the clinical management of patients [8] . The entity manifests as thromboembolic complications, with ischemic stroke being the most common and typically the initial presentation. Other recurrent complications include ","cbCaigpAolqrElCN","https://ap.wps.com/l/cbCaigpAolqrElCN","pdf",6231875,16,"English","# Abstract\n## Introduction\n## Methods\n## Results and Discussion\n## Conclusion\n# Keywords\n# Case Report\n## Clinical presentation\n## Diagnosis and imaging","[{\"question\":\"What is cancer-associated NBTE and why is it clinically challenging?\",\"answer\":\"NBTE is characterized by sterile vegetations on heart valves caused by systemic hypercoagulability, commonly associated with advanced malignancies. It is frequently underdiagnosed and often first recognized after thromboembolic events such as ischemic stroke.\"},{\"question\":\"What does the reported case show about rivaroxaban in maintaining anticoagulation?\",\"answer\":\"The case documents a positive response to rivaroxaban as maintenance anticoagulation, with 3D echocardiographic evidence of reduced valvular vegetations over follow-up.\"},{\"question\":\"How did DOAC outcomes compare with heparin in the systematic review?\",\"answer\":\"Across the included case reports, many patients were already receiving DOACs before NBTE diagnosis. After diagnosis, anticoagulation often shifted from DOACs to heparin, and low-molecular-weight heparin showed better outcomes regarding vegetation resolution and prevention of thromboembolic events.\"}]","Cancer-associated Marantic Endocarditis and Direct Oral Anticoagulants - Case Report and Systematic Review | PDF",1790082761]