Torkan Ali, Dehghan Houman, Tajmirriahi Marzieh, Zavar Reihaneh
Fellowship of Echocardiography, Echocardiography department, Chamran Cardiovascular Medical and Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Chamran Cardiovascular Medical and Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2025;21(4):55-78. doi: 10.48305/arya.2025.45107.3045.
Nonbacterial thrombotic endocarditis (NBTE) is a rare yet critical complication in cancer patients, with high embolic risk and poor prognoses. This systematic review investigates the clinical presentation, valve involvement, embolic risk, vegetation management, and prognostic variability across cancer types in NBTE cases.
Adhering to PRISMA guidelines, we conducted a comprehensive literature search in PubMed, Scopus, and Embase for studies from 2000 to September 2024. Extracted data included demographics; cancer type and site; NBTE diagnosis timing; valve characteristics; embolic events; and patient outcomes. Chi-square and regression analyses evaluated associations among clinical variables and outcomes. Quality was appraised using the Joanna Briggs Institute tool.
From 38 studies comprising 40 cases, the mean patient age was 50.5 years (±12.5), with equal gender distribution (20 males, 20 females). Pancreatic adenocarcinoma (17.5%) and lung adenocarcinoma (15.0%) were most frequently associated with NBTE. Mortality rates varied significantly by cancer type, with gastrointestinal and urogenital cancers showing the highest rates. A significant association was found between cancer type and vegetation management strategy (χ² = 24.41, p = 0.018). Further correlations indicated that longer cancer histories necessitated more invasive management, and concurrent embolic events correlated with poorer prognoses. Quality assessment reinforced the findings' reliability (65% high quality).
NBTE in cancer patients shows distinct clinical and prognostic patterns, with cancer type impacting both management and outcomes. These insights highlight the importance of tailored management approaches and provide a basis for future research to enhance care and prognostic assessments in NBTE cases within oncology.
非细菌性血栓性心内膜炎（NBTE）是癌症患者中一种罕见但严重的并发症，具有高栓塞风险和不良预后。本系统评价调查了NBTE病例中不同癌症类型的临床表现、瓣膜受累情况、栓塞风险、赘生物处理及预后差异。
遵循PRISMA指南，我们在PubMed、Scopus和Embase中对2000年至2024年9月的研究进行了全面的文献检索。提取的数据包括人口统计学信息；癌症类型和部位；NBTE诊断时间；瓣膜特征；栓塞事件；以及患者结局。采用卡方检验和回归分析评估临床变量与结局之间的关联。使用乔安娜·布里格斯研究所工具评估质量。
在38项包含40例病例的研究中，患者平均年龄为50.5岁（±12.5），性别分布均衡（男性20例，女性20例）。胰腺腺癌（17.5%）和肺腺癌（15.0%）与NBTE关联最为频繁。死亡率因癌症类型而异，胃肠道和泌尿生殖系统癌症的死亡率最高。发现癌症类型与赘生物处理策略之间存在显著关联（χ² = 24.41，p = 0.018）。进一步的相关性表明，癌症病史越长，所需的侵入性处理越多，同时发生的栓塞事件与预后较差相关。质量评估加强了研究结果的可靠性（65%为高质量）。
癌症患者中的NBTE表现出独特的临床和预后模式，癌症类型对处理和结局均有影响。这些见解凸显了针对性处理方法的重要性，并为未来研究提供了基础，以加强肿瘤学中NBTE病例的护理和预后评估。
