Comparison of Enoxaparin and Warfarin for Secondary Prevention of Cancer-Associated Stroke
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 includ...
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Veröffentlicht in: | Journal of Oncology 2015-01, Vol.2015 (2015), p.246-251 |
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Sprache: | eng |
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Zusammenfassung: | 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. |
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ISSN: | 1687-8450 1687-8450 1687-8469 |
DOI: | 10.1155/2015/502089 |