期刊
JOURNAL OF ONCOLOGY
卷 2015, 期 -, 页码 -出版社
HINDAWI LTD
DOI: 10.1155/2015/502089
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-
类别
资金
- Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea [HI13C1521]
Background. The aim of this study was to determine which anticoagulant is superior for secondary prevention of cancer-associated stroke, using changes in D-dimer levels as a biomarker for recurrent thromboembolic events. Methods. We conducted a retrospective, single center observational study including patients with cancer-associated stroke who were treated with either enoxaparin or warfarin. Blood samples for measuring the initial and follow-up D-dimer levels were collected at admission and a median of 8 days after admission, respectively. Multiple logistic regression analysis was conducted to evaluate the factors that influenced D-dimer levels after treatment. Results. Although the initial D-dimer levels did not differ between the two groups, the follow-up levels were dramatically decreased in patients treated with enoxaparin, while they did not change with use of warfarin (3.88 mu g/mL versus 17.42 mu g/mL, p=0.026). On multiple logistic regression analysis, use of warfarin (OR 12.95; p=0.001) and the presence of systemic metastasis (OR 18.73; p=0.017) were independently associated with elevated D-dimer levels (>= 10 mu g/mL) after treatment. Conclusion. In cancer-associated stroke patients, treatment with enoxaparin may be more effective than treatment with warfarin for lowering the D-dimer levels. Future prospective studies are warranted to show that enoxaparin is better than warfarin for secondary prevention in cancer-associated stroke.
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