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- Title
Comparison of Enoxaparin and Warfarin for Secondary Prevention of Cancer-Associated Stroke.
- Authors
Jang, Hyemin; Lee, Jung Jae; Lee, Mi Ji; Ryoo, Sookyung; Yoon, Chang Hyo; Kim, Gyeong-Moon; Chung, Chin-Sang; Lee, Kwang Ho; Bang, Oh Young; Kim, Suk Jae
- Abstract
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 μg/mL versus 17.42 μg/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 μg/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.
- Subjects
STROKE prevention; ENOXAPARIN; WARFARIN; ANTICOAGULANTS; FIBRIN fragment D; CANCER complications; THERAPEUTICS
- Publication
Journal of Oncology, 2015, Vol 2015, p1
- ISSN
1687-8450
- Publication type
Article
- DOI
10.1155/2015/502089