In cancer patients, the development of NBTE is thought to involve procoagulant secretion by mucin-producing adenocarcinoma, platelet activation by mucin, and vascular endothelial damage and tissue factor activation by inflammatory cytokines (IL-1, IL-6, tumor necrosis factor) released from tumor-activated monocytes/macrophages. Here, MUC5AC is linked to adenocarcinoma.