Stroke in cancer patients: a risk factor analysis
- 588 Downloads
Background and Purpose In patients already suffering from cancer, the additional occurrence of stroke can aggravate the burden of the disease. The purpose of this study was to compare risk factors for haemorrhagic and ischemic strokes in cancer and non-cancer patients. Methods A retrospective analysis, including 1,274 stroke patients admitted to a stroke unit, was conducted from 2004 to 2007. Classical risk factors for stroke and clinical outcome measures were compared between cancer and non-cancer patients. Results Twelve percent of stroke patients had an additional diagnosis of cancer. In the non-cancer population, 84% had ischemic and 16% had haemorrhagic strokes. In cancer patients, 86% had ischemic and 14% had haemorrhagic strokes. Vascular risk factors in cancer patients, including hypertension, atrial fibrillation, coronary vessel disease, smoking, hypercholesterolemia and diabetes mellitus, showed no difference compared to the non-cancer population. Only thrombotic events occurred more often in the cancer cohort. The most frequent cancer types were urogenital, breast and gastrointestinal. Regarding clinical outcome, cancer patients had an inferior neurological condition at discharge and a trend towards a longer stay in the stroke unit. Conclusions The frequency of ischemic and haemorrhagic stroke in tumour patients is similar to that in the non-cancer population. Cerebrovascular risk factors do not significantly vary between cancer and non-cancer patients. The higher frequency of thrombotic events in cancer patients may reflect a coagulation disorder, commonly found in patients with malignancy. Clinical outcome in cancer patients may be worsened by the pre-existent co-morbidity.
KeywordsCerebrovascular risk factors Neurooncology Stroke and cancer
This work was supported by funding from the European Community’s Sixth Framework Programme (Contract LSSM-CT-2005-518174). It reflects only the authors’ views and the Community is not liable for any use that may be made of the information contained herein.
- 3.Posner JB (1995) Vascular disorders. In: Posner JB (ed) Neurologic complications of cancer. Davies, Philadelphia, pp 199–299Google Scholar
- 9.Yashin AI, Ukraintseva SV, Akushevich IV, Arbeev KG, Kulminski A, Akushevich L (2008) Trade-off between cancer and aging: what role do other diseases play? Evidence from experimental and human population studies. Mech Ageing Dev :25. (Epub ahead of print)Google Scholar
- 10.Cestari DM, Weine DM, Panageas KS, Segal AZ, De Angelis LM (2004) Stroke in patients with cancer: incidence and aetiology. Neurology 64:2025–2030Google Scholar
- 27.Herrera dP, Esteban EE, Gimenez SJV, Pareja MA, Moscoso dP (2004) Nonbacterial thrombotic endocarditis as initial event of lung cancer. An Med Interna 21:495–497Google Scholar
- 28.Ojeda VJ, Frost F, Mastaglia FL (1985) Non-bacterial thrombotic endocarditis associated with malignant disease: a clinicopathological study of 16 cases. Med J Aust 42:629–631Google Scholar