Stroke and cancer: a review

Grisold, Wolfgang; Oberndorfer, Stefan; Struhal, W.

doi:10.1111/j.1600-0404.2008.01059.x

Cited by 205 publications

(194 citation statements)

References 119 publications

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“…Cancer cells secrete procoagulant factors that may induce a hypercoagulable state causing ischemic stroke and other thromboembolic complications (Bick, 2003). In clinical practice, cancer‐related stroke is considered rare and difficult to diagnose (Grisold, Oberndorfer, & Struhal, 2009). In our study, several of these patients were initially classified as CE because of infarcts in multiple vascular territories.…”

Section: Discussionmentioning

confidence: 99%

Thirty‐day recurrence after ischemic stroke or TIA

et al. 2018

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BackgroundIncidence of recurrent stroke is highest within 30 days after the initial ischemic stroke (IS) or TIA, but knowledge about early recurrence is lacking. We aimed to identify etiological groups with highest risk of early recurrence and assess how the TOAST classification identified index stroke etiology.MethodsMedical records of 1874 IS and TIA patients in the Bergen NORSTROKE registry were retrospectively reviewed for identification of recurrent IS or TIA within 30 days after index IS or TIA. Stroke etiology was determined by review of electronical medical journals. Logistic regression was used to calculate odds ratios (OR) for 30‐day recurrence.ResultsThirty‐three patients (1.8%) were readmitted with recurrent IS or TIA within 30 days after index stroke. By using TOAST, 12 patients were initially classified with stroke of unknown etiology (SUE). Etiologies behind recurrent IS or TIA were after the recurrent episode identified as extracranial large artery atherosclerosis (LAA) in 14 patients (42.4%), intracranial arterial pathology in seven patients (21.2%), active malignancy in six patients (18.2%), and cardio embolism in four patients (12.1%). Small vessel occlusion and SUE were the causes in one patient each. Logistic regression showed that patients with stroke of other determined etiology (SOE) and LAA had increased risk of 30‐day recurrence (OR = 9.72, 95% CI 1.84–51.3, p < 0.01 and OR = 4.36, 95% CI 2.01–9.47, p < 0.01, respectively).ConclusionPatients with LAA and SOE had increased risk of recurrent IS or TIA within 30 days. TOAST was inadequate at identifying exact etiologies behind recurrent stroke at index event.

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Section: Discussionmentioning

confidence: 99%

Thirty‐day recurrence after ischemic stroke or TIA

et al. 2018

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“…[12][13][14] All of these have been detected in patients with lung cancer. 7,13,14 We observed that the incidence of stroke was higher in the lung cancer group than in the comparison group among patients without conventional stroke risk factors, but not in those with conventional risk factors. This result may support the findings of the Korean study, which suggested that stroke patients with conventional mechanisms may not have cancer-related mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Lung Cancer and Incidence of Stroke

Chen

Muo

Lee

et al. 2011

Stroke

104

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Background and Purpose-Stroke is a known cerebrovascular complication in lung cancer patients; however, whether lung cancer patients are at elevated risk of developing stroke relative to the noncancer population remains unclear. Methods-The present study used population-based claims data from the Taiwan National Health Insurance, which identified 52 089 patients with an initial diagnosis of lung cancer between 1999 and 2007, and 104 178 matched noncancer subjects from all insured subjects age 20 years and older. Subsequent occurrence of stroke was measured until 2008, and the association between lung cancer and the hazard of developing stroke was estimated using Cox proportional hazard models. Results-The incidence of stroke was 1.5 times higher (25.9 versus 17.4 per 1000 person-years) in the lung cancer group compared with the comparison group. The multivariate-adjusted hazard ratio (HR) comparing lung cancer patients with the noncancer group was 1.47 (95% CI, 1.39 -1.56) for stroke, 1.78 (95% CI, 1.54 -2.05) for hemorrhagic stroke, and 1.43 (95% CI, 1.34 -1.51) for ischemic stroke. The risk of stroke fell over time, decreasing after 1 year of follow-up for men and after 2 years of follow-up for women. Within the first year of follow-up, the risk of stroke peaked during the first 3 months for men and within 4 to 6 months for women. Conclusions-Lung cancer is associated with increased risk of subsequent stroke within 1 year after diagnosis for men and 2 years after diagnosis for women. (Stroke. 2011;42:3034-3039.)

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“…A comprehensive overview concerning the various cancer-associated stroke mechanisms and the risk of chemotherapy and radiation in this context is given elsewhere. [19][20][21][22] Thromboembolic complications in patients with cancer are of special importance among these. 2,3,5,22,23 Nevertheless, this association is often underestimated, in particular in those patients who are not known to have cancer once the stroke signs and symptoms occur.…”

Section: Discussionmentioning

confidence: 99%

Stroke and Cancer

Schwarzbach

Schaefer

Ebert

et al. 2012

Stroke

223

117

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Background and Purpose-The importance of cancer-associated hypercoagulability as a possible stroke etiology in patients with cancer has received relatively little attention to date. A recent study has suggested that cancer-associated hypercoagulation may be of special importance in the absence of conventional stroke mechanisms. Methods-We identified patients with ischemic stroke sequentially admitted to our stroke center with the additional diagnosis of active and malignant cancer from 2002 to 2011. By using our prospectively collected stroke, MRI, and laboratory data banks, the etiology and risk factors of stroke, types of cancer, deep vein thrombosis/pulmonary embolism, d-dimer levels, and diffusion-weighted imaging lesion patterns were compared to an age-and sex-matched control group. Patients with cancer with a conventional stroke etiology and patients with an unidentified and/or cancer-associated stroke etiology were analyzed separately. Results-One hundred forty patients with cancer and 140 control subjects were included. Unidentified stroke (P<0.001) and infarction in multiple vascular territories (P<0.001) were significantly more frequent and d-dimer levels significantly higher (P<0.05) in patients with cancer. Vice versa, risk factors such as hypertension (P<0.05) and hyperlipidemia (P<0.01) were more prevalent in control subjects. Deep vein thrombosis and pulmonary embolism were more frequent (P<0.01) and d-dimer levels higher (P<0.01) in the patients with unidentified and/or cancerassociated stroke etiology compared to the patients with cancer with a conventional stroke etiology. Lung and pancreatic cancer were significantly overrepresented and d-dimer levels higher in these patients compared with other patients with cancer (P<0.01). Conclusions-Our data confirm the concept of cancer-associated hypercoagulation as a widely underestimated important stroke risk factor in patients with cancer, especially in those with severely elevated

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Stroke and cancer: a review

Cited by 205 publications

References 119 publications

Thirty‐day recurrence after ischemic stroke or TIA

Thirty‐day recurrence after ischemic stroke or TIA

Lung Cancer and Incidence of Stroke

Stroke and Cancer

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