Risk Factors and Biomarkers of Ischemic Stroke in Cancer Patients
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background and Purpose: Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. Methods: A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for stroke and stroke subtypes in cancer patients were compared with age- and sex-matched noncancer patients with ischemic stroke who were admitted to the same hospital during the same period. Results: One hundred fifty-six cancer patients with ischemic stroke were identified. Cancer patients with ischemic stroke were found to have a significantly lower proportion of hypertension, atrial fibrillation, hyperlipidemia, and ischemic heart disease than noncancer patients with ischemic stroke. However, stroke biomarkers, such as erythrocyte sedimentation rate and high-sensitivity C-reactive protein, fibrinogen, pro-brain natriuretic peptide, and D-dimer levels, were significantly increased in cancer patients with ischemic stroke than in noncancer patients. Large-artery atherosclerosis and stroke of undetermined cause were more common in cancer patients with ischemic stroke than in noncancer patients with ischemic stroke. Conclusions: Cancer patients with ischemic stroke showed different risk factors, stroke biomarkers, and stroke etiology compared with noncancer patients with ischemic stroke.
Abstract
Background and Purpose: Stroke is common among cancer patients. However, risk factors and biomarkers of stroke in cancer patients are not well established. This study aimed to investigate risk factors and biomarkers as well as etiology of ischemic stroke in cancer patients. Methods: A retrospective review was conducted in cancer patients with ischemic stroke who were admitted to a general hospital in Busan, Korea, between January 2003 and December 2012. The risk factors and biomarkers for stroke and stroke subtypes in cancer patients were compared with age- and sex-matched noncancer patients with ischemic stroke who were admitted to the same hospital during the same period. Results: One hundred fifty-six cancer patients with ischemic stroke were identified. Cancer patients with ischemic stroke were found to have a significantly lower proportion of hypertension, atrial fibrillation, hyperlipidemia, and ischemic heart disease than noncancer patients with ischemic stroke. However, stroke biomarkers, such as erythrocyte sedimentation rate and high-sensitivity C-reactive protein, fibrinogen, pro-brain natriuretic peptide, and D-dimer levels, were significantly increased in cancer patients with ischemic stroke than in noncancer patients. Large-artery atherosclerosis and stroke of undetermined cause were more common in cancer patients with ischemic stroke than in noncancer patients with ischemic stroke. Conclusions: Cancer patients with ischemic stroke showed different risk factors, stroke biomarkers, and stroke etiology compared with noncancer patients with ischemic stroke.
참고문헌 (30)
- Graus F., "Cerebrovascular complications in patients with cancer", Medicine(Baltimore), 64, pp.16~35 (1985)
- Chaturvedi S., "Should cerebral ischemic events in cancer patients be considered a manifestation of hypercoagulability?", Stroke, 25, pp.1215~1218 (1994)
- Hiatt BK., "Prothrombotic States that Predispose to Stroke", Curr Treat Options Neurol, 4, pp.417~425 (2002)
- Kim SG., "Ischemic stroke in cancer patients with and without conventional mechanisms : a multicenter study in Korea", Stroke, 41, pp.798~801 (2010)
- Seok JM., "Coagulopathy and embolic signal in cancer patients with ischemic stroke", Ann Neurol, 68, pp.213~219 (2010)
- Suk Jae Kim, "Biomarkers for Stroke", 대한뇌졸중학회지, 15(1), pp.27~37 (2013), 대한뇌졸중학회[DOI]
- Montaner J., "Etiologic diagnosis of ischemic stroke subtypes with plasma biomarkers", Stroke, 39, pp.2280~2287 (2008)
- Alvarez-Perez FJ., "Usefulness of measurement of fibrinogen, D-dimer, D-dimer", fibrin-ogen ratio, C reactive protein and erythrocyte sedimentation rate to assess the pathophysiology and mechanism of ischaemic stroke, 2011, pp.82, 986~992
- Adams HP Jr., "Baseline NIH Stroke Scale score strongly predicts outcome after stroke : a report of the Trial of Org 10172 in Acute Stroke Treatment(TOAST)", Neurology, 53, pp.126~131 (1999)
- Cestari DM., "Stroke in patients with cancer : incidence and etiology", Neurology, 62, pp.2025~2030 (2004)
- Grisold W., "Stroke and cancer : a review", Acta Neurol Scand, 119, pp.1~16 (2009)
- Stefan O., "Stroke in cancer patients : a risk factor analysis", J Neurooncol, 94, pp.221~226 (2009)
- Kim JM., "Clinical manifestation of cancer related stroke : retrospective case-control study", J Neurooncol, 111, pp.295~301 (2013)
- Zhang YY., "Stroke risk factor, pattern and outcome in patients with cancer", Acta Neurol Scand, 114, pp.378~383 (2006)
- Schwarzbach CJ., "Stroke and cancer : the importance of cancerassociated hypercoagulation as a possible stroke etiology", Stroke, 43, pp.3029~3034 (2012)
- Kono T., "Cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer", Geriatr Gerontol Int, 12, pp.468~474 (2012)
- Wilde JT., "Plasma D-dimer levels and their relationship to serum fibrinogen", fibrin degradation products in hypercoagulable states, 1989, pp.71, 65~70
- 방오영, "Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes", Journal of Clinical Neurology, 7(2), pp.53~59 (2011), 대한신경과학회
- Rothwell PM., "Fibrinogen concentration and risk of ischemic stroke and acute coronary events in 5113 patients with transient ischemic attack and minor ischemic stroke", Stroke, 35, pp.2300~2305 (2004)
- Prugger C., "Multiple biomarkers for the prediction of ischemic stroke : the PRIME study", Arterioscler Thromb Vasc Biol, 33, pp.659~666 (2013)
- Whiteley W., "The use of blood biomarkers to predict poor outcome after acute transient ischemic attack or ischemic stroke", Stroke, 43, pp.86~91 (2012)
- Shibazaki K., "Plasma brain natriuretic peptide can be a biological marker to distinguish cardioembolic stroke from other stroke types in acute ischemic stroke", Intern Med, 48, pp.259~264 (2009)
- Pasceri V., "Direct proinflammatory effect of C-reactive protein on human endothelial cells", Circulation, 102, pp.2165~2168 (2000)
- Anuk T., "Prognostic implications of admission inflammatory profile in acute ischemic neurological events", Acta Neurol Scand, 106, pp.196~199 (2002)
- Welch GN., "Homocysteine and atherothrombosis", N Eng J Med, 338, pp.1042~1050 (1998)
- Jeong SK., "Homocysteine and internal carotid artery occlusion in ischemic stroke", J Atheroscler Thromb, 17, pp.963~969 (2010)
- Perry IJ., "Homocysteine and risk of stroke", J Cardiovasc Risk, 6, pp.235~240 (1999)
- Mulrooney DA., "Vascular injury in cancer survivors", J Cardiovasc Transl Res, 5, pp.287~295 (2012)
- Libby P., "Inflammation in atherosclerosis", Nature, 420, pp.868~874 (2002)
- Shishehbor MH., "Inflammation and atherosclerosis", Curr Atheroscler Rep, 6, pp.131~139 (2004)