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
N1 - Funding Information:
Grant support: This work was supported by the R&D support grant (O1600161) of Korea University Guro Hospital, Republic of Korea and by the Ministry of Health and Welfare (HI 16C1078), Korea. The funding organization had no role in the study or the preparation of this report.
Funding Information:
Grant support: This work was supported by the R&D support grant ( O1600161 ) of Korea University Guro Hospital, Republic of Korea and by the Ministry of Health and Welfare ( HI 16C1078 ), Korea. The funding organization had no role in the study or the preparation of this report.
Publisher Copyright:
© 2017 National Stroke Association
PY - 2017/12
Y1 - 2017/12
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 - Ischemic stroke
KW - NOAC
KW - anticoagulation
KW - cancer
KW - hypercoagulability
KW - prognosis
UR - http://www.scopus.com/inward/record.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
SN - 1052-3057
VL - 26
SP - 2976
EP - 2980
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 12
ER -
