Prior Cancer in Patients with Ischemic Stroke: The Bergen NORSTROKE Study

Selvik, Henriette Aurora; Thomassen, Lars; Logallo, Nicola; Næss, Halvor

doi:10.1016/j.jstrokecerebrovasdis.2013.07.041

Cited by 59 publications

(56 citation statements)

References 143 publications

(174 reference statements)

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“…Also contradictory results have been published on the distribution of traditional stroke risk factors. 13,14 We found associations between heavy drinking, smoking, age >40 years, and poststroke cancer.…”

Section: Discussionmentioning

confidence: 79%

“…[14][15][16] With this background, our study on consecutive and well-characterized patient population with first-ever ischemic stroke is unique.…”

Section: Discussionmentioning

confidence: 99%

“…The National Institutes of Health Stroke Scale (NIHSS) was used to assess stroke severity at admission, 1 and was further divided into mild (0-6), moderate (7)(8)(9)(10)(11)(12)(13)(14), and severe (≥15) subgroups. Brain imaging on admission was performed for all patients either with CT or MRI.…”

Section: Online Supplementmentioning

confidence: 99%

“…10,13 Little is known about cancer among young and middle-aged patients with ischemic stroke. [14][15][16] Young patients traditionally have more ischemic strokes with nonconventional stroke mechanisms and undetermined pathogenesis compared with older stroke patients. 17,18 The prevalence of cancer has been higher among young stroke patients compared with the general population of similar age.…”

mentioning

confidence: 99%

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Cancer in Young Adults With Ischemic Stroke

Aarnio

Joensuu

Haapaniemi

et al. 2015

Stroke

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Background and Purpose— Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke. Methods— 1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5–13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan–Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality. Results— One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0–9.5) years and from stroke to poststroke cancer was 6.7 (2.7–10.9) years. Poststroke cancer was associated with age >40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%–85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%–23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators. Conclusions— Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients.

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Section: Discussionmentioning

confidence: 79%

“…[14][15][16] With this background, our study on consecutive and well-characterized patient population with first-ever ischemic stroke is unique.…”

Section: Discussionmentioning

confidence: 99%

Section: Online Supplementmentioning

confidence: 99%

mentioning

confidence: 99%

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Cancer in Young Adults With Ischemic Stroke

Aarnio

Joensuu

Haapaniemi

et al. 2015

Stroke

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“…A recent prospective study also emphasizes the role of cancer activity in vascular profile distinction between cancer and non-cancer patients. 15 On the other hand, another recent study, The Bergen NORSTROKE Study 16 identified that patients with ischemic stroke and a previous history of cancer had a higher frequency of specific vascular risk factors (atrial fibrillation, heart disease and smoking), highlighting the fact that cancer and stroke have common risk factors. In our series of patients, there were no differences concerning vascular profile between active and non-active cancer patients, which could be explained by the limited number of patients with an active malignancy.…”

Section: Discussionmentioning

confidence: 99%

Acute Ischemic Stroke on Cancer Patients, a Distinct Etiology? A Case-Control Study

2015

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Discussion: In our case-control study two subsets of cancer patients were delineated. In a subgroup, cancer and stroke co-exist, sharing traditional vascular risk factors. In another subset of patients, stroke appears to be directly related to the presence of a malignancy, where hypercoagulopathy turns out to be a decisive mechanism. Conclusion:In clinical grounds, hypercoagulopathy as stroke etiology should prompt the physician to screen the patient for occult cancer.

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