Abstract
Background Low-molecular weight heparin (LMWH) was shown to be effective and safe in treating venous thromboembolism, and generally used for stroke in cancer patients, but its effects on stroke are unclear. We compared clinical outcomes between LMWH and new oral anticoagulant (NOAC) in patients with cancer-related stroke. Methods We enrolled patients with cryptogenic ischemic stroke with active cancer who were treated with LMWH or NOAC between May 2012 and June 2015. The clinical outcomes, including early neurologic deterioration, early radiologic recurrence, 3-month modified Rankin scale score, 90-day mortality, cardio-cerebrovascular recurrence, and bleeding complications, were compared. Results Among 48 patients, 7 patients were treated with NOAC, and the remaining 41 patients with LMWH. Overall, the participants presented poor outcomes, including 20 (42%) early neurologic deteriorations, 28 (58%) early radiologic recurrences, 34 (71%) poor modified Rankin scale scores, 27 (56%) 90-day mortality events, 24 (50%) cardio-cerebrovascular recurrences, and 18 (38%) bleeding complications, that led to a change or temporary hold in medication in 12 cases. No statistical differences were found between the 2 groups in terms of demographic, clinical, or cardiovascular risk factors and clinical outcomes. Conclusions NOAC showed the similar clinical outcomes and safety compared with LMWH in the treatment of cryptogenic ischemic stroke in active cancer patients.
| Original language | English |
|---|---|
| Pages (from-to) | 2976-2980 |
| Number of pages | 5 |
| Journal | Journal of Stroke and Cerebrovascular Diseases |
| Volume | 26 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2017 Dec 1 |
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Keywords
- anticoagulation
- cancer
- hypercoagulability
- Ischemic stroke
- NOAC
- prognosis
ASJC Scopus subject areas
- Surgery
- Rehabilitation
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
Cite this
Treatment of Cryptogenic Stroke with Active Cancer with a New Oral Anticoagulant. / Nam, Ki Woong; Kim, Chi Kyung; Kim, Tae Jung; An, Sang Joon; Oh, Kyungmi; Ko, Sang Bae; Yoon, Byung Woo.
In: Journal of Stroke and Cerebrovascular Diseases, Vol. 26, No. 12, 01.12.2017, p. 2976-2980.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of Cryptogenic Stroke with Active Cancer with a New Oral Anticoagulant
AU - Nam, Ki Woong
AU - Kim, Chi Kyung
AU - Kim, Tae Jung
AU - An, Sang Joon
AU - Oh, Kyungmi
AU - Ko, Sang Bae
AU - Yoon, Byung Woo
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background Low-molecular weight heparin (LMWH) was shown to be effective and safe in treating venous thromboembolism, and generally used for stroke in cancer patients, but its effects on stroke are unclear. We compared clinical outcomes between LMWH and new oral anticoagulant (NOAC) in patients with cancer-related stroke. Methods We enrolled patients with cryptogenic ischemic stroke with active cancer who were treated with LMWH or NOAC between May 2012 and June 2015. The clinical outcomes, including early neurologic deterioration, early radiologic recurrence, 3-month modified Rankin scale score, 90-day mortality, cardio-cerebrovascular recurrence, and bleeding complications, were compared. Results Among 48 patients, 7 patients were treated with NOAC, and the remaining 41 patients with LMWH. Overall, the participants presented poor outcomes, including 20 (42%) early neurologic deteriorations, 28 (58%) early radiologic recurrences, 34 (71%) poor modified Rankin scale scores, 27 (56%) 90-day mortality events, 24 (50%) cardio-cerebrovascular recurrences, and 18 (38%) bleeding complications, that led to a change or temporary hold in medication in 12 cases. No statistical differences were found between the 2 groups in terms of demographic, clinical, or cardiovascular risk factors and clinical outcomes. Conclusions NOAC showed the similar clinical outcomes and safety compared with LMWH in the treatment of cryptogenic ischemic stroke in active cancer patients.
AB - Background Low-molecular weight heparin (LMWH) was shown to be effective and safe in treating venous thromboembolism, and generally used for stroke in cancer patients, but its effects on stroke are unclear. We compared clinical outcomes between LMWH and new oral anticoagulant (NOAC) in patients with cancer-related stroke. Methods We enrolled patients with cryptogenic ischemic stroke with active cancer who were treated with LMWH or NOAC between May 2012 and June 2015. The clinical outcomes, including early neurologic deterioration, early radiologic recurrence, 3-month modified Rankin scale score, 90-day mortality, cardio-cerebrovascular recurrence, and bleeding complications, were compared. Results Among 48 patients, 7 patients were treated with NOAC, and the remaining 41 patients with LMWH. Overall, the participants presented poor outcomes, including 20 (42%) early neurologic deteriorations, 28 (58%) early radiologic recurrences, 34 (71%) poor modified Rankin scale scores, 27 (56%) 90-day mortality events, 24 (50%) cardio-cerebrovascular recurrences, and 18 (38%) bleeding complications, that led to a change or temporary hold in medication in 12 cases. No statistical differences were found between the 2 groups in terms of demographic, clinical, or cardiovascular risk factors and clinical outcomes. Conclusions NOAC showed the similar clinical outcomes and safety compared with LMWH in the treatment of cryptogenic ischemic stroke in active cancer patients.
KW - anticoagulation
KW - cancer
KW - hypercoagulability
KW - Ischemic stroke
KW - NOAC
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85028310010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028310010&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2017.07.029
DO - 10.1016/j.jstrokecerebrovasdis.2017.07.029
M3 - Article
C2 - 28843806
AN - SCOPUS:85028310010
VL - 26
SP - 2976
EP - 2980
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
SN - 1052-3057
IS - 12
ER -