title: Ischemic stroke in cancer patients treated with direct oral anticoagulants for venous thromboembolism.
abstract: Direct oral anticoagulants (DOACs) are at least as efficacious as conventional anticoagulation therapy for the initial and long-term treatment of cancer patients with venous thromboembolism (VTE). Whether DOACs are non-inferior to low-molecular-weight heparin for the management of cancer patients with VTE is under investigation. In addition, the efficacy of DOACs for the treatment of cancer patients with arterial thrombosis (e.g., ischemic stroke) remains unclear. Herein, we report on two cancer patients admitted to our hospital with Stage IV gastric adenocarcinoma who were being treated with DOACs due to a history of VTE and had developed their first ever ischemic stroke, which was diagnosed due to cancer-related hypercoagulation. Notably, neither patient had recurrence of VTE during the course of their disease. In cancer-related thrombosis, DOACs effectively reduce VTE, but may be insufficient for preventing ischemic stroke.
authors.affiliation: Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: gon@neurol.med.osaka-u.ac.jp.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Gon
authors.affiliation: Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakaguchi
authors.affiliation: Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Takasugi
authors.affiliation: Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mochizuki
mesh_terms: D000230:Adenocarcinoma / Q000150:complications*; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000150:complications*; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control*; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000925:Anticoagulants
keywords: Cancer-related thrombosis; Direct oral anticoagulant; Ischemic stroke; Venous thromboembolism