Comparison of Enoxaparin and Warfarin for Secondary Prevention of Cancer-Associated Stroke
Open Access
- 1 January 2015
- journal article
- research article
- Published by Hindawi Limited in Journal of Oncology
- Vol. 2015, 1-6
- https://doi.org/10.1155/2015/502089
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,). On multiple logistic regression analysis, use of warfarin (OR 12.95;) and the presence of systemic metastasis (OR 18.73;) 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.
Keywords
Funding Information
- Ministry of Health and Welfare (HI13C1521)
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