{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T19:24:20Z","timestamp":1789932260266,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100028771","name":"Mayo Clinic Health System","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100028771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Premortem clinical presentation of cancer\u2010associated non\u2010bacterial thrombotic endocarditis (Ca\u2010NBTE), therapy, and the clinal course is limited to case reports and small clinical series. An electronic search of Mayo Clinic records (03\/31\/2002\u201306\/30\/2022) with a subsequent manual review was performed to identify adult patients with echocardiographically detected NBTE and active malignancy, excluding those with infectious endocarditis or lupus anticoagulant\/antiphospholipid antibodies. In this retrospective cohort study, we analyzed 115 Ca\u2010NBTE patients (mean age 63.2\u2009\u00b1\u20099.7\u2009years, 66.1% female) involving 71 (61.7%) mitral, 58 (50.4%) aortic, 8 (6.9%) tricuspid, and 1 (0.9%) pulmonary valve. The most common cancer was lung (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200945 cases (39.1%), followed by pancreatic (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200919, 16.5%), gynecological (17, 14.8%), gastrointestinal (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910, 8.7%), and 10 (8.7%) with hematologic malignancy; 6 patients had two active cancers. Embolic complications at presentation were frequent: 94 (81.7%) brain, 11 splenic, 10 renal, 6 coronary, and 4 to the extremities. Of 104 anticoagulated patients, 60 received low molecular weight heparin, 17 unfractionated heparin, 16 apixaban, 8 warfarin, and 3 rivaroxaban. There were 18 arterial thromboembolisms; the Kaplan\u2013Meier estimates of the incidence at 2\u2009years were consistent with a rate of 15.9% [95% Confidence Interval (CI) 9.9\u201323.3], including 14 strokes (12.4%, 95%CI, 7.1\u201319.2), and 8 other arterial emboli (10.5%, 95%CI, 4.7\u201318.9); there were 10 venous thromboembolisms (8.9%, 95%CI, 4.5\u201315.0). Fourteen major bleedings occurred (12.8%, 95%CI, 7.3\u201319.9) and 94 patients died during follow\u2010up (77.9%, 95%CI, 71.1\u201385.8). Ca\u2010NBTE predominantly affected women with lung adenocarcinoma or digestive tract cancers and manifested by stroke with high mortality and frequent embolic and bleeding complications during anticoagulation therapy.\n                  <\/jats:p>","DOI":"10.1002\/ajh.27239","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T04:16:22Z","timestamp":1707797782000},"page":"596-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cancer\u2010associated non\u2010bacterial thrombotic endocarditis\u2014Clinical series from a single institution"],"prefix":"10.1002","volume":"99","author":[{"given":"Patryk","family":"Patrzalek","sequence":"first","affiliation":[{"name":"Cardiovascular Disease, Gonda Vascular Center Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Cardiovascular Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8119-6206","authenticated-orcid":false,"given":"Waldemar E.","family":"Wysokinski","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease, Gonda Vascular Center Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Cardiovascular Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto D.","family":"Kurmann","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease, Gonda Vascular Center Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Cardiovascular Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damon","family":"Houghton","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease, Gonda Vascular Center Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Cardiovascular Diseases Mayo Clinic  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