Prior Cancer in Patients with Ischemic Stroke: The Bergen NORSTROKE Study
Prior Cancer in Patients with Ischemic Stroke: The Bergen NORSTROKE Study
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DOI：
10.1016/j.jstrokecerebrovasdis.2013.07.041
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发表时间：
2014-05-01
影响因子：
2.5
通讯作者：
Naess, Halvor
中科院分区：
文献类型：
--
作者：
Selvik, Henriette A.;Thomassen, Lars;Naess, Halvor
背景：比较缺血性卒中患者和普通人群中既往或正在发生癌症的患病率。我们假设心源性卒中是既往癌症患者中最常见的卒中病因，既往癌症的缺血性卒中患者（ISP）的结局较差。方法：所有在挪威卒中研究登记处（NORSTROKE）登记的ISP均纳入研究，作为正在进行的卑尔根NORSTROKE研究的一部分。卒中病因由急性卒中治疗标准中的10172试验确定，卒中的严重程度由国立卫生研究院卒中量表评分定义。关于既往或正在进行的癌症疾病和类型的信息是从病历和挪威癌症登记处回顾性获得的。将中风患者的癌症患病率与普通人群的癌症患病率进行比较。结果：在1456例ISP中，229例（15.7%）患者在卒中前有1种或多种癌症诊断。与一般人群相比，中风患者的癌症患病率较高（P = 0.001）。最常见的癌症类型是结直肠癌（20.2%）、前列腺癌（15.6%）、乳腺癌（12.7%）、泌尿系统癌症（10.3%）、妇科癌症（6.2%）和肺癌（4.5%）。Logistic回归分析显示，有癌症病史的患者心源性卒中的发生率更高（P = 0.03）。结论：ISP中既往癌症的患病率高于一般人群。患有癌症的ISP更容易发生心源性栓塞。
Background: To compare the prevalence of prior or on-going cancer in patients with ischemic stroke and in the general population. We hypothesized that cardioembolic stroke is the most common stroke etiology in patients with prior cancer and that the outcome for ischemic stroke patients (ISP) with prior cancer is poor. Methods: All ISP registered in the Norwegian Stroke Research Registry (NORSTROKE) as part of the ongoing Bergen NORSTROKE Study were included. Stroke etiology was determined by the Trial of Org 10172 in Acute Stroke Treatment criteria, and the severity of the stroke was defined from the National Institutes of Health Stroke Scale score. Information about prior or ongoing cancer disease and type was retrospectively obtained from the medical patient record and The Cancer Registry of Norway. The prevalence of cancer among stroke patients was compared with the prevalence of cancer in the general population. Results: Among 1456 ISP, 229 (15.7%) patients had 1 or more cancer diagnoses before the stroke. The prevalence of cancer was higher among stroke patients compared with the general population (P = .001). The most common cancer types were colorectal cancer (20.2%), prostate cancer (15.6%), breast cancer (12.7%), cancer of the urinary tract system (10.3%), gynecological cancer (6.2%), and lung cancer (4.5%). Logistic regression analysis showed that patients with prior cancer had cardioembolic strokes at a higher rate (P = .03). Conclusions: The prevalence of prior cancer is higher in ISP than in the general population. ISPs with prior cancer are more prone to cardioembolism.