Fujinami J, et al. - In ischemic stroke patients with active cancer, researchers evaluated the occurrence and predictive factors of short-term stroke recurrence. In addition, they assessed if cancer-associated hypercoagulation was linked to early recurrent stroke. A high risk of early recurrent stroke was seen in ischemic stroke patients with active cancer. An independent predictor of early recurrent stroke in these patients was the concurrence of high D-dimer (hDD) levels (≥ 10.4 µg/mL) and multiple vascular territory infarctions (MVTI). It was noted that early recurrent stroke risk is increased by cancer-associated hypercoagulation.

Methods

• For this investigation, acute ischemic stroke patients with active cancer admitted to the hospital between 2006 and 2017 were retrospectively enrolled.
• Active cancer was characterized as diagnosis or treatment for any cancer within a year prior to stroke onset, known recurrent cancer or metastatic disease.
• Recurrent ischemic stroke within 30 days was the primary clinical outcome.

Results

• In this analysis, 110 acute ischemic stroke patients with active cancer (73 men, age 71.3 ± 10.1 years) were selected.
• Out of 110 acute ischemic stroke patients with active cancer, recurrent stroke occurred in 12 patients (11%).
• Researchers found that those with recurrent stroke had a higher incidence of pancreatic cancer (33 vs 10%), systemic metastasis (75 vs 39%), MVTI (83 vs 40%), and higher ­D-dimer levels (16.9 vs 2.9 μg/mL) vs those without recurrent stroke.
• Multivariable logistic regression analysis demonstrated that each factor mentioned above was not significantly related to stroke recurrence independently.
• On the other hand, hDD levels (≥10.4 μg/mL) and MVTI together were significantly related to stroke recurrence (OR 6.20, 95% CI 1.42–30.7, p=0.015).