Cancer-associated stroke: a study of prevalence and predictors among ischaemic stroke patients
*Correspondencia: Dra. Yolanda Bravo Anguiano. Calle Morros Alts 8, bung. 2. E-03560 El Campello, Alicante.
E-mail: bravoy@gmail.com
Introduction: The association between cancer and stroke is well documented and entails a worse prognosis for both pathologies. However, the prevalence of active and occult cancer among stroke patients is not sufficiently established, and neither are the predictors of cancer-associated stroke. Their knowledge is important for better identification and optimisation of the treatment of these patients.
Patients and methods: The aim of this retrospective study is to analyse the characteristics of ischaemic stroke in patients with and without active cancer in a sample of patients admitted to a stroke unit for two years. An overall descriptive and case-control analysis is performed to assess the differences between the two groups.
Results: In a sample of 616 patients with ischaemic stroke, a prevalence of cancer was found to be 19.2%, which was active (prior or diagnosed after the stroke) in 7.5% of them. Active cancer was associated with the finding of lesions in several vascular territories, lower haemoglobin and haematocrit values, and higher fibrinogen and C-reactive protein values, a tendency to worse functional status and higher mortality at three months.
Conclusions: A high prevalence of systemic cancer, of any type, as well as active and occult, was found among patients with ischaemic stroke. The presence of ischaemic lesions in several vascular territories and some laboratory markers could be factors to consider in attributing the stroke to cancer or looking for an occult neoplasm in some patients.
Pacientes y métodos El objetivo de este estudio retrospectivo es analizar las características del ictus isquémico, en pacientes con y sin cáncer activo, en una muestra de pacientes ingresados durante dos años en una unidad de ictus. Se realiza un análisis descriptivo general y de casos y controles, para evaluar las diferencias entre ambos grupos.
Resultados En una muestra de 616 pacientes con ictus isquémico se encontró una prevalencia de cáncer del 19,2%, que era activo (previo o diagnosticado tras el ictus) en un 7,5%. El cáncer activo se asoció con el hallazgo de lesiones en varios territorios vasculares, valores más bajos de hemoglobina y hematocrito, y más altos de fibrinógeno y proteína C reactiva, tendencia a peor situación funcional y mayor mortalidad a los tres meses.
Conclusiones Se encontró una alta prevalencia de cáncer sistémico, de cualquier tipo, y también activo y oculto, entre pacientes con ictus isquémico. La presencia de lesiones isquémicas en varios territorios vasculares y algunos marcadores de laboratorio podrían ser factores que habría que considerar para atribuir el ictus al cáncer o buscar una neoplasia oculta en algunos pacientes.