Risk Factors, Biomarkers, Etiology, Outcome and Prognosis of Ischemic Stroke in Cancer Patients

Abstract

Introduction: Cerebrovascular disease is the second most common complication in individuals with tumours.<br />The aim of this study was to investigate risk factors, biomarkers, etiology and prognosis of ischemic stroke in cancer<br />patients (ISCPs). Methods: The medical records of 619 consecutive patients who were admitted with acute ischemic<br />stroke from January 2012 to November 2014 were retrospectively evaluated. The patients were divided into two groups<br />(group 1, patients with an active cancer prior to the onset of ischemic stroke; group 2, patients without an active cancer<br />history). The demographic data, risk factors, NIHSS scores, thrombocyte count, D-dimer, fibrinogen and C reactive<br />protein (CRP) level at admission, modified Rankin Scale (mRS) scores in the follow-up period and location of lesions<br />on DWI were recorded. The Mann-Whitney U test, chi-squared test and logistic regression was used for analyzing data,<br />pwas significantly lower in the ISCP group (p=0.001). Elevated thrombocyte counts, D-dimer, fibrinogen and CRP levels<br />at admission, acute multiple ischemic lesions, other causes, mortality in hospital and worse outcome were significantly<br />related to ISCP (p<0.05). On logistic regression analysis, follow up mRS>3, acute multiple ischemic lesions located<br />in more than one vascular territory (AMIMCT) and other causes were significantly associated with ISCP (p<0.001).<br />Conclusion: In our study, other causes, AMIMCT and mRS>3 were more common in the ISCP group. We consider that<br />CCS could be more suitable for detecting other causes than TOAST. Biomarkers could be important in the ISCP group.