Anna G Karlińska1, Grażyna Gromadzka2, Michał A Karliński2, Anna Członkowska3. 1. Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. Electronic address: akarlinska@ipin.edu.pl. 2. Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. 3. Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
Abstract
BACKGROUND: It has been suggested that stroke in patients with cancer may differ from the conventional pattern. The aim of this study was to evaluate the burden of vascular risk factors, stroke etiology, and short-term outcome in patients with active and nonactive malignancy compared with patients without cancer. METHODS: This is a prospective cohort study of consecutive acute stroke patients admitted to our department between September 2006 and September 2011. We distinguished between the following: (1) patients with active malignancy (AM, diagnosed not earlier than 12 months before stroke); (2) patients with nonactive malignancy (non-AM); and (3) cancer-free (CF) patients, used as a reference. RESULTS: Pre-existing cancer was found in 90 of 1558 patients, including 41 (2.6%) cases with AM and 49 (3.1%) cases with non-AM. Compared with CF patients, AM patients less frequently had a history of previous stroke (2.4% versus 17.9%, P = .018) and more frequently experienced ischemic strokes of undetermined etiology (62.5% versus 38.3%, P = .002). Non-AM patients did not differ in the distribution of vascular risk factors but more often experienced stroke caused by small vessel occlusion (20.0% versus 8.0%, P = .004). Inflammatory blood markers were elevated especially in patients with AM. Short-term prognosis was similar across all groups. CONCLUSIONS: Stroke pattern in patients with non-AM appears very similar to that observed in the CF patients. However, our findings support the thesis that cancer-specific prothrombotic mechanisms play an important role in stroke patients with AM, which may be related to active inflammatory and immune processes. Malignancy does not influence short-term prognosis of stroke.
BACKGROUND: It has been suggested that stroke in patients with cancer may differ from the conventional pattern. The aim of this study was to evaluate the burden of vascular risk factors, stroke etiology, and short-term outcome in patients with active and nonactive malignancy compared with patients without cancer. METHODS: This is a prospective cohort study of consecutive acute strokepatients admitted to our department between September 2006 and September 2011. We distinguished between the following: (1) patients with active malignancy (AM, diagnosed not earlier than 12 months before stroke); (2) patients with nonactive malignancy (non-AM); and (3) cancer-free (CF) patients, used as a reference. RESULTS: Pre-existing cancer was found in 90 of 1558 patients, including 41 (2.6%) cases with AM and 49 (3.1%) cases with non-AM. Compared with CFpatients, AM patients less frequently had a history of previous stroke (2.4% versus 17.9%, P = .018) and more frequently experienced ischemic strokes of undetermined etiology (62.5% versus 38.3%, P = .002). Non-AM patients did not differ in the distribution of vascular risk factors but more often experienced stroke caused by small vessel occlusion (20.0% versus 8.0%, P = .004). Inflammatory blood markers were elevated especially in patients with AM. Short-term prognosis was similar across all groups. CONCLUSIONS:Stroke pattern in patients with non-AM appears very similar to that observed in the CFpatients. However, our findings support the thesis that cancer-specific prothrombotic mechanisms play an important role in strokepatients with AM, which may be related to active inflammatory and immune processes. Malignancy does not influence short-term prognosis of stroke.
Authors: Markus Kneihsl; Christian Enzinger; Gerit Wünsch; Michael Khalil; Valeriu Culea; Tadeja Urbanic-Purkart; Franz Payer; Kurt Niederkorn; Franz Fazekas; Thomas Gattringer Journal: J Neurol Date: 2015-11-03 Impact factor: 4.849