Abstract 210: The Risk Of A Diagnosis Of Cancer After Ischemic Stroke: Two Year Follow-up Study Of 3247 Cancer Free Ischemic Stroke Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Ahmed A Malik ◽  
Omar Saeed ◽  
Malik M Adil ◽  
Fareed K Suri
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
General Population ◽  
Composite Endpoint ◽  
Annual Rate ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Incident Cancer ◽  
Age Adjusted Rates

Background: Subclinical cancer can manifest as a thrombo-embolic event and may be detected at a later interval in ischemic stroke survivors. Objective: To determine the rate of incident cancer and effect on cardiovascular endpoints in a large cohort of ischemic stroke survivors. Methods: An analysis of 3680 adults with non-disabling cerebral infarction who were followed for two years within the randomized, double-blinded VISP trial was performed. We calculated age adjusted rates of incidence of cancer among ischemic stroke survivors and calculated the standardized incidence ratios (SIR) with 95% confidence intervals (CI) based on comparison with age-adjusted rates in the general population. A logistic regression analysis evaluated the association between incident cancer and various endpoints including stroke, coronary heart disease, myocardial infarction, and death after adjusting age, gender, and race/ethnicity. Results: A total of 3247 patients (mean age (±SD) of 66 (±11); 2013 were men) were cancer free at the time of enrollment. The incidence of new cancer was 0.15, 0.80, 1.2, and 2.0 per 100 patients at 1 month, 6 month, 1 year, and 2 years, respectively. The age adjusted annual rate of cancer in patients with ischemic stroke over 1 year after recruitment was 581.8/100,000 persons which was higher than the age adjusted cancer rate of 486.5/100,000 persons in the general population (SIR 1.2, 95% CI 1.16-1.24). The age adjusted annual rate continued to be higher in patients with ischemic stroke over 2 years after recruitment (1301.7/100,000 versus 911.5/100,000, SIR 1.4, 95% CI 1.2-1.6). There was a higher risk for death (OR 3.1, 95% CI, 1.8-5.4), fatal/disabling stroke or death (OR 2.3, 95% CI 1.4-3.7), and composite endpoint of stroke, coronary heart disease, and/or death (OR 1.4, 95% CI 1.0-2.2) among participants who developed incident cancer compared with those who were cancer free after adjusting for potential confounders. Conclusions: The annual rate of age adjusted cancer incidence was higher among ischemic stroke patients compared with general population. The risk of mortality was three folds greater among stroke survivors who developed incident cancer.

scholarly journals Incident Cancer in a Cohort of 3,247 Cancer Diagnosis Free Ischemic Stroke Patients

2015 ◽  
Vol 39 (5-6) ◽  
pp. 262-268 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Ahmed A. Malik ◽  
Omar Saeed ◽  
Malik M. Adil ◽  
Gustavo J. Rodriguez ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
General Population ◽  
Annual Rate ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Incident Cancer ◽  
Race Ethnicity ◽  
Age Adjusted Rates

Background: Subclinical cancer can manifest as a thromboembolic event and may be detected at a later interval in ischemic stroke survivors. We determined the rate of incident cancer and effect on cardiovascular endpoints in a large cohort of ischemic stroke survivors. Methods: An analysis of 3,680 adults with nondisabling cerebral infarction who were followed for two years within the randomized, double-blinded VISP trial was performed. The primary intervention was best medical/surgical management plus a daily supplementation of vitamin B6, vitamin B12, and folic acid. We calculated age-adjusted rates of incidence of cancer among ischemic stroke survivors and standardized incidence ratios (SIR) with 95% confidence intervals (CI) based on comparison with age-adjusted rates in the general population. The significant variables from univariate analysis were entered in a Cox Proportional Hazards analysis to identify the association between various baseline factors and incident cancer after adjusting age, gender, and race/ethnicity. A logistic regression analysis evaluated the association between incident cancer and various endpoints including stroke, coronary heart disease, myocardial infarction, and death after adjusting age, gender, and race/ethnicity. Results: A total of 3,247 patients (mean age ± SD of 66 ± 11; 2,013 were men) were cancer free at the time of enrollment. The incidence of new cancer was 0.15, 0.80, 1.2, and 2.0 per 100 patients at 1 month, 6 months, 1 year, and 2 years, respectively. The age-adjusted annual rate of cancer in patients with ischemic stroke was higher than in persons in the general population at 1 year (581.8/100,000 persons vs. 486.5/100,000 persons, SIR 1.2, 95% CI 1.16-1.24) and 2 years (1,301.7/100,000 vs. 911.5/100,000, SIR 1.4, 95% CI 1.2-1.6) after recruitment. There was a higher risk for death (odds ratio (OR) 3.1, 95% CI 1.8-5.4), and composite endpoint of stroke, coronary heart disease, and/or death (OR 1.4, 95% CI 1.0-2.2) among participants who developed incident cancer compared with those who were cancer free after adjusting for potential confounders. Conclusions: The annual rate of age-adjusted cancer incidence was higher among ischemic stroke patients compared with those in the general population. The odds of mortality were three folds higher among stroke survivors who developed incident cancer.

scholarly journals KORELASI ANTARA RASIO NEUTROFIL LIMFOSIT DENGAN VOLUME INFARK SEREBRI PADA PENDERITA STROKE ISKEMIK AKUT

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ilsa Hunaifi ◽  
Triana Dyah Cahyawati
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Infarct Volume ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Cross Sectional Design

 CORRELATION BETWEEN NEUTROFIL LIMPHOCYTE RATIO AND CEREBRAL INFARCTION VOLUME IN ACUTE ISCHAEMIC STROKEABSTRACTIntroduction: Inflammation plays a key role in stroke pathophysiology. Neutrophils is one of the earliest leucocyte subtypes to infiltrate the ischemia area of the brain. The neutrophil-lymphocyte ratio (NLR) is independent of the severity of coronary heart disease and as a predictor of poor clinical outcomes in patients with coronary heart disease undergoing angiography. The neutrophil-lymphocyte ratio values may be a prognostic factor in ischemic stroke patients. The neutrophil- lymphocyte ratio values can also be used in predicting infarct size, however limited study has been conducted in this area.Aim: To determine the correlation of NLR with cerebral infarct volume in acute ischemic stroke patients.Method: This was an analytical observational study with cross sectional design. The population for this study were acute ischemic stroke patients at NTB Genereal Hospital. The collected data were analyzed by Spearman correlation test.Results: Approximately 52 participants  were enrolled in this study with mean age was 59.79±8.65 years old. Hypertension was a common modifiable risk factor identified in more than 94.2 % participant. The mean of neutrophil lymphocyte ratio was 3.94±2.96 and mean of infarct volume was 13.96±37.26cm3. There was correlation between RNL and cerebral infract volume (r=+0.351; p=0.023).Discussions: Higher lymphocyte neutrophil ratio in acute ischemic stroke patients would result in an increase of brain infarct volume.Keyword: Infarct volume, ischaemic stroke, neutrophil lymphocyte ratioABSTRAKPendahuluan: Inflamasi memegang peranan penting dalam patofisiologi stroke. Salah satu subtipe dari sel leukosit yang paling awal menginfiltrasi ke area iskemia di otak adalah neutrofil. Rasio neutrofil limfosit (RNL) merupakan faktor independen terhadap beratnya penyakit jantung koroner dan sebagai prediktor luaran klinis yang buruk pada penderita penyakit jantung koroner yang menjalani angiografi. Nilai RNL dapat menjadi faktor prognostik pada penderita stroke iskemik. Nilai RNL juga bisa digunakan dalam memprediksi ukuran infark namun belum dilakukan penelitian hingga saat ini.Tujuan: Mengetahui korelasi RNL dengan volume infark serebri pada penderita stroke iskemik akut.Metode: Penelitian analitik observasional dengan desain potong lintang terhadap pasien stroke iskemik akut di RSUP NTB. Data yang terkumpul dianalisis dengan uji korelasi Spearman.Hasil: Didapatkan 52 subjek dengan rerata umur 59,79±8,65 tahun dan faktor risiko utama hipertensi (94,2%). Didapatkan rerata rasio neutrofil limfosit 3,94±2,96 dan rerata volume infark 13,96±37,26cm3. Terdapat korelasi antara RNL dengan volume infark serebri (r=+0,351; p=0,023).Diskusi: Semakin tinggi nilai rasio neutrofil limfosit mengakibatkan semakin luasnya volume infark serebri pada penderita stroke iskemik akut.Kata kunci: Rasio neutrofil limfosit, stroke iskemik, volume infark  

scholarly journals Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Huan Tang ◽  
Shenqiang Yan ◽  
Chenglong Wu ◽  
Yanxing Zhang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Intravenous Thrombolysis ◽  
Unfavorable Outcome ◽  
Cardioembolic Stroke ◽  
Stroke Patients ◽  
Early Neurological Deterioration ◽  
Baseline Systolic Blood Pressure ◽  
History Of

Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients.Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome.Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients.Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months.

scholarly journals Metabolic Syndrome in Patients With First-ever Ischemic Stroke: Prevalence and Association With Coronary Heart Disease

2021 ◽  
Author(s):  
Yajun Liang ◽  
Zhongrui Yan ◽  
Yanlei Hao ◽  
Qiqi Wang ◽  
Zuoji Zhang ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
International Diabetes Federation ◽  
Binary Logistic Regression ◽  
University Hospitals ◽  
Stroke Patients ◽  
Stroke Prevalence ◽  
Low Hdl

Abstract Background: Most studies of metabolic syndrome (MetS) and coronary heart disease (CHD) have been carried out in the general population, and their association among stroke patients has been rarely explored. We seek to describe the prevalence of MetS among patients with acute ischemic stroke and to assess its association with CHD. Methods: This hospital-based study included 1851 patients with first-ever acute ischaemic stroke (mean age 61.2 years, 36.5% women) who were hospitalized into two university hospitals in Shandong, China (January 2016-February 2017). Data were collected through interviews, physical examinations, and laboratory tests. MetS was defined following the National Cholesterol Education Program (NCEP) criteria, the International Diabetes Federation (IDF) criteria, and the Chinese Diabetes Society (CDS) criteria. CHD was defined according to clinical and electrocardiogram examinations. Binary logistic regression was performed to determine the associations between MetS and CHD. Results: The overall prevalence of MetS was 34.0% by NECP criteria, 47.8% by IDF criteria, and 32.9% by CDS criteria. The prevalence of MetS decreased with age and was higher in women than men (p<0.05). Abdominal obesity, high blood pressure, high triglycerides, and low HDL-C were significantly associated with CHD (multi-adjusted OR range: 1.27-1.43, p<0.05). Compared with those without MetS, the multi-adjusted OR (95% CI) of CHD associated with MetS defined by the NECP criteria, IDF criteria, and CDS criteria was 1.29 (1.04-1.59), 1.46 (1.20-1.78), and 1.29 (1.05-1.59), respectively. In addition, having 1-2 abnormal components (vs. none) was associated with CHD (OR range: 1.63-1.73, p<0.05). Conclusions: MetS affects over one-third of patients with first-ever ischemic stroke. MetS is associated with an increased likelihood of CHD in stroke patients, but treating MetS as a binary entity would underestimate its association with CHD.

scholarly journals The CHADS2 score predicts ischemic stroke in the absence of atrial fibrillation among subjects with coronary heart disease: Data from the Heart and Soul Study

2011 ◽  
Vol 162 (3) ◽  
pp. 555-561 ◽  
Author(s):  
Christine C. Welles ◽  
Mary A. Whooley ◽  
Beeya Na ◽  
Peter Ganz ◽  
Nelson B. Schiller ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Chads2 Score
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