{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:01:42Z","timestamp":1788418902842,"version":"build-2803163510"},"reference-count":22,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,1]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Non-bacterial thrombotic endocarditis (NBTE) is a rare condition related to a state of hypercoagulability in advanced neoplastic disease. Most of the time, arterial thromboembolic event precedes the diagnosis of NBTE. We report here a case of NBTE responsible for multiple ischaemic strokes, which leads to the diagnosis of metastatic pancreatic adenocarcinoma. Aortic and mitral valvular regurgitations secondary to NBTE appeared within 6 weeks despite therapeutic anticoagulation with direct oral anticoagulant (DOAC) in stroke prevention of paroxysmal atrial fibrillation. Bivalvular regurgitations resolved 8 weeks after therapeutic switch to low-molecular-weight heparin (LMWH) and chemotherapy. DOACs are a possible alternative to LMWH for the prevention of venous thromboembolism in patients with active neoplasia. There is a lack of evidence for a clinical efficiency for the prevention of arterial thromboembolism in NBTE. We propose here a short review of the efficacy of anticoagulant therapy for the prevention of arterial thromboembolism in NBTE.<\/jats:p>","DOI":"10.1136\/bcr-2021-247672","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T12:12:03Z","timestamp":1647432723000},"page":"e247672","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Reversibility of valve regurgitation due to cancer-related non-bacterial thrombotic endocarditis after switching direct oral anticoagulation for heparin"],"prefix":"10.1136","volume":"15","author":[{"given":"Maxence","family":"Lepour","sequence":"first","affiliation":[{"name":"Department of Cardiology, Clinique Saint Pierre, Ottignies, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7540-8068","authenticated-orcid":false,"given":"Gr\u00e9goire J F G","family":"Wie\u00ebrs","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Clinique Saint-Pierre, Ottignies, Belgium"},{"name":"Department of Medicine, Universit\u00e9 de Namur, Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Vereeke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint Pierre, Ottignies, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lien","family":"Wauters","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint Pierre, Ottignies, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"2025082702321979000_15.3.e247672.1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-5-518"},{"key":"2025082702321979000_15.3.e247672.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp030086"},{"key":"2025082702321979000_15.3.e247672.3","first-page":"159","article-title":"The valvulopathy of non-bacterial thrombotic endocarditis","volume":"18","author":"Silbiger","year":"2009","journal-title":"J Heart Valve Dis"},{"key":"2025082702321979000_15.3.e247672.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv319"},{"key":"2025082702321979000_15.3.e247672.5","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1378\/chest.11-2305","article-title":"Antithrombotic and thrombolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed. 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