Marta Vales Montero (Spain)
Hospital General Universitario Gregorio Marañón NeurologyAuthor Of 1 Presentation
ISCHEMIC STROKE AND ACTIVE CANCER: AN IMPORTANT ASSOCIATION WITH SPECIFIC MARKERS.
Abstract
Background and Aims
To describe the characteristics of ischemic stroke (IS) in patients with active cancer (AC) and to identify AC markers in patients with cryptogenic stroke (CS).
Methods
Analysis of a prospective registry of IS patients admitted to a Stroke unit between May-2019 and January-2021. AC cases were identified and compared to the rest of the cohort (non-active cancer [NAC]). Additionally, the characteristics of CS with and without AC were compared.
Results
1,931 IS were included, 61 patients (3.1%) had AC. Non-lacunar and cryptogenic stroke were more frequent in the AC compared to the NAC group (85.7% vs 62.6%, p=0.001 and 49.2% vs 30.4%, p=0.003). No small vessel disease etiology was observed in the AC group (0% vs 22%, p<0.0001). Stroke were more severe in patients with CS + AC compared with CS without AC (median NIHSS 6 and 4, p=0.03). Additionally, Patients with CS + AC had lower hemoglobin levels (median 11.95 g/dL vs 13.8 g/dL, p=0.022) and higher C-reactive protein (CRP) (1.19 mg/dL vs 0.39 mg/dL, p=0.014) and D-Dimer (842 ng/mL vs 272 ng/mL, p<0.0001) compared with CS without AC. The AUC in the ROC analysis was 0.722 (95% CI 0.604 - 0.851) for D-Dimer and 0.725 (0.628 - 0.822) for RCP. Sensitivity and specificity for D-Dimer ≥420 ng/mL was 74.1% and 70%, and 65.5% and 70.7% for RCP ≥0.805 mg/dL.
Conclusions
Cryptogenic stroke is more frequent in patients with active cancer. Increased D-Dimer and RCP may help predict the presence of active cancer in patients with cryptogenic stroke.