Cancer‐associated ischemic stroke is associated with elevated <scp>d</scp>‐dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer

Kono, Tomoyuki; Ohtsuki, Toshiho; Hosomi, Naohisa; Takeda, Ikuko; Aoki, Shiro; Sueda, Yoshimasa; Ishihara, K; Nakamura, Takeshi; Yamawaki, Takemori; Matsumoto, Masayasu

doi:10.1111/j.1447-0594.2011.00796.x

Cited by 54 publications

(49 citation statements)

References 16 publications

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“…10 Cancer patients with cryptogenic stroke have higher D-dimer levels and more frequently infarcts located in multiple vascular territories than patients with stroke associated with other pathogenesis. [11][12][13] The frequency of traditional ischemic stroke risk factors among cancer patients differs between studies. 10,13 Little is known about cancer among young and middle-aged patients with ischemic stroke.…”

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confidence: 99%

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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Cancer in Young Adults With Ischemic Stroke

Aarnio

Joensuu

Haapaniemi

et al. 2015

Stroke

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“…These results suggest that patients with multiple lesions may have had occult cancer. 21 Moreover, it is possible that late-stage cancer may possibly influence D-dimer levels 20 or ischemic lesion patterns, 7 although we did not collect detailed information regarding patient cancer histories. The second major finding was the association of the presence of multiple infarcts and long-term stroke outcomes.…”

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confidence: 99%

“…[17][18][19] Additionally, D-dimer levels are closely associated with cancer-associated stroke. 7,20 Several studies have shown that cancer-associated stroke may correlate with multiple ischemic lesion patterns. 7,21 Herein, our findings showed that patients with multiple lesions had higher rates for the history of cancer than patients with single or scattered lesions (16.9% versus 9.7%; P=0.120).…”

Section: Discussionmentioning

confidence: 99%

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Multiple Infarcts Are Associated With Long-Term Stroke Recurrence and All-Cause Mortality in Cryptogenic Stroke Patients

Nezu

Mukai

Uemura

et al. 2016

Stroke

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C ryptogenic stroke accounts for 20% to 40% of all ischemic strokes.1,2 High risk of stroke recurrence has been reported in cryptogenic stroke patients. 3,4 However, the indicators related to stroke recurrence have not been fully elucidated. Moreover, recurrent stroke prevention strategies are lacking; therefore, cryptogenic stroke persists as a serious issue.Diffusion-weighted magnetic imaging (DWI) is a widely used and essential modality in clinical settings for the diagnosis of ischemic stroke. In addition, ischemic lesion patterns identified via DWI images are useful for classifying stroke subtype. Multiple ischemic lesions (observed by DWI) are associated with the occurrence of right-to-left shunting (RLS), aortic arch atheroma, and cancer-associated stroke among ischemic and cryptogenic stroke patients. [5][6][7] However, it is unclear whether ischemic lesion patterns predict stroke recurrence in cryptogenic stroke patients.In this study, we used DWI images to assess the association between ischemic lesion patterns and clinical characteristics among cryptogenic ischemic stroke patients according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. 8 Additionally, we investigated the prognosis of cryptogenic stroke patients and determined whether patient ischemic lesion patterns predict long-term stroke outcomes. Methods SubjectsThis was a retrospective, observational study. This study complied with the Declaration of Helsinki for investigations involving humans, and the study protocol was approved by the Ethics Committee of the Kawasaki Medical School Hospital. We enrolled consecutive, acute ischemic stroke patients who were admitted to the Kawasaki Medical School Hospital within 7 days of stroke onset between April 2008 and March 2012. A total of 1338 acute ischemic stroke patients were classified according to the TOAST criteria. Among these patients, we excluded patients with small vessel occlusion (n=221), large artery atherosclerosis (n=137), and cardioembolism (n=412). Of the remaining 568 patients, we diagnosed 122 patients with stroke caused by Background and Purpose-Brain infarct patterns that are observed via diffusion-weighted imaging are useful for classifying stroke subtypes. However, it is unclear whether infarct patterns can predict long-term outcomes in cryptogenic stroke patients. Herein, we investigated the association between acute brain infarct patterns and long-term stroke outcomes in cryptogenic stroke patients. Methods-Acute cryptogenic stroke patients were consecutively enrolled between April 2008 and March 2012. Diffusionweighted imaging ischemic lesion patterns were classified as single lesions, scattered lesions in one vascular territory, or multiple lesions in multiple vascular territories. Survivors (at discharge) were followed up for 3 years after stroke onset. Clinical Information During HospitalizationPatient data were collected by attending physicians including age, sex, body mass index, known vascular risk factors (eg, hypertension, diabetes mellitus, and ...

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“…Однако сочетание данной симптоматики с измененными показа-телями крови и данными о наличии тромбоза являются сигналом для дообследования па-циента. Помимо этого, универсальными мар-керами любого ракового процесса являются повышение фибриногена, С-реактивного бел-ка, D-димера [8,9].…”

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Cancer as a Cause of Stroke in Young Adults

Nikitenko¹,

Karnaukh²,

Никитенко³

et al. 2017

AMJ

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Амурский медицинский журнал №1 (17) 2017Ежегодно в России диагностируется более 50 тыс. новых случаев рака желудка (РЖ) и около 45 тыс. больных умирают от этого забо-левания [1,10]. Аденокарцинома желудка яв-ляется одной из наиболее распространенных и прогностически неблагоприятных злокаче-ственных опухолей, так как скрытый период РЖ весьма длителен и может протекать от 10 месяцев до 5 лет [2]. Кроме того, дебют за-болевания может протекать отлично от клас-сической клинической картины поражения раком органа. Примером тому служит ниже приведенный клинический случай.Больной Т., 36 лет, поступил в приемное отделение городской клинической больницы г. Благовещенска с жалобами на слабость и онемение в левых конечностях, нарушение речи. Данное состояние развилось ночью. Ле-карственные препараты не принимает, АД не контролировал. Вредные привычки: злоупо-требление алкоголем, курение (стаж -10 лет по пачке в день).Состояние средней степени тяжести. Тело-сложение астеническое. Сознание ясное, кри-тичен. Температура тела 36,4° С. Тоны сердца приглушены, ритм правильный, 76 в минуту. АД 160/100 мм рт. ст. Живот при пальпации болезненный в зоне эпигастрия. Симптом Щеткина-Блюмберга отрицательный. Печень РЕЗЮМЕ Рак желудка -жизнеугрожающая патоло-гия. Долгое время она может протекать бес-симптомно и дебютировать поражением дру-гих органов и систем. В статье приводится клинический случай манифестации аденокар-циномы желудка ишемическим инсультом.Ключевые слова: аденокарцинома желуд-ка, паранеопластический синдром, ишемиче-ский инсульт у лиц молодого возраста. DOI CANCER AS A CAUSE OF STROKE IN YOUNG ADULTSP.S. Nikitenko, A.I. Karnaukh, S.V. Nikitenko, A.A. Kumsкov, N.S. Soetova, I.E. Solovyova, М.V. Ruder ABSTRACT Stomach cancer is considered to be life-threatening pathology. However, it also can be asymptomatic for a long time and occur by attacking other organs and systems. There is a clinical case of gastric adenocarcinoma's manifestation in the form of an ischemic stroke in this article.

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Cancer‐associated ischemic stroke is associated with elevated d‐dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer

Abstract: In acute ischemic stroke, the cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation products, even after controlling hypertension, hyperlipidemia and advanced cancer (clinical stage IV).

Cited by 54 publications

References 16 publications

Cancer in Young Adults With Ischemic Stroke

Cancer in Young Adults With Ischemic Stroke

Multiple Infarcts Are Associated With Long-Term Stroke Recurrence and All-Cause Mortality in Cryptogenic Stroke Patients

Cancer as a Cause of Stroke in Young Adults

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