Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study

Gon, Yasufumi; Sakaguchi, Manabu; Yamagami, Hiroshi; Abe, Soichiro; Hashimoto, Hiroyuki; Ohara, Nobuyuki; Takahashi, Daisuke; Abe, Yuko; Takahashi, Tsutomu; Kitano, Takaya; Okazaki, Shuhei; Todo, Kenichi; Sasaki, Tsutomu; Hattori, Satoshi; Mochizuki, Hideki

doi:https://doi.org/10.1161/JAHA.123.029618

Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study

Gon, Yasufumi; Sakaguchi, Manabu; Yamagami, Hiroshi et al.

Journal of the American Heart Association, 2023, 12(15), e029618

アクセス数:2,164件（2025-09-01 14:42 集計）

固定URL: https://hdl.handle.net/11094/92491

閲覧可能ファイル

ファイル	フォーマット	利用条件	サイズ	閲覧回数	利用開始日	説明	information
JAmHeartAssoc_12_15_e029618	pdf	なし	1.17 MB	183	2023.09.07

Creative Commons : 表示 - 非営利 - 改変禁止

論文情報

ファイル出力 EndNote Basic出力 Mendeley出力

タイトル	Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study
著者	NRID 1000070751311 1000070751311 researchmap permalink y-gon y-gon Scopus Author ID 56565092900 56565092900 著者名 Gon, Yasufumi
	著者名 Sakaguchi, Manabu
	著者名 Yamagami, Hiroshi
	著者名 Abe, Soichiro
	著者名 Hashimoto, Hiroyuki
	著者名 Ohara, Nobuyuki
	著者名 Takahashi, Daisuke
	著者名 Abe, Yuko
	著者名 Takahashi, Tsutomu
	著者名 Kitano, Takaya
	NRID 1000060623072 1000060623072 researchmap permalink s-okazaki s-okazaki Scopus Author ID 16417354000 16417354000 著者名 Okazaki, Shuhei
	NRID 1000040403068 1000040403068 researchmap permalink kenichitodo kenichitodo Scopus Author ID 22954718500 22954718500 著者名 Todo, Kenichi
	NRID 1000020534879 1000020534879 ORCID 0000-0001-8726-978X 0000-0001-8726-978X researchmap permalink tsutomusasaki1111 tsutomusasaki1111 Scopus Author ID 7407394272 7407394272 著者名 Sasaki, Tsutomu
	NRID 1000050425154 1000050425154 researchmap permalink hattori_satoshi hattori_satoshi Scopus Author ID 35728877500 35728877500 著者名 Hattori, Satoshi
	NRID 1000090230044 1000090230044 ORCID 0000-0002-0874-7542 0000-0002-0874-7542 researchmap permalink read0207787 read0207787 Scopus Author ID 7202006099 7202006099 著者名 Mochizuki, Hideki
キーワード等	active cancer
	cryptogenic stroke
	D-dimer
	distant metastasis
	ischemic stroke
内容	Gon Y., Sakaguchi M., Yamagami H., et al. Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study. Journal of the American Heart Association 12, e029618 (2023); https://doi.org/10.1161/JAHA.123.029618.
抄録	BACKGROUND: Limited data exist on the prognostic factors for patients with ischemic stroke and active cancer. METHODS AND RESULTS: We conducted a prospective, multicenter, observational study in Japan, including patients with acute ischemic stroke and active cancer, to investigate the prognostic factors. We followed up the patients for 1 year after stroke onset. The patients were divided into 2 groups according to cryptogenic stroke and known causes (small-vessel occlusion, large-artery atherosclerosis, cardioembolism, and other determined cause), and survival was compared. The hazard ratios (HRs) and 95% CIs for mortality were calculated using Cox regression models. We identified 135 eligible patients (39% women; median age, 75 years). Of these patients, 51% had distant metastasis. A total of 65 (48%) and 70 (52%) patients had cryptogenic stroke and known causes, respectively. Patients with cryptogenic stroke had significantly shorter survival than those with known causes (HR [95% CI], 3.11 [1.82–5.32]). The multivariable Cox regression analysis revealed that distant metastasis, plasma D-dimer levels, venous thromboembolism (either deep venous thrombosis or pulmonary embolism) complications at stroke onset were independent predictors of mortality after adjusting for potential confounders. Cryptogenic stroke was associated with prognosis in univariable analysis but was not significant in multivariable analysis. The plasma D-dimer levels stratified the prognosis of patients with ischemic stroke and active cancer. CONCLUSIONS: The prognosis of patients with acute ischemic stroke and active cancer varied considerably depending on stroke mechanism, distant metastasis, and coagulation abnormalities. The present study confirmed that coagulation abnormalities were crucial in determining the prognosis of such patients.
出版者	American Heart Association Inc.
収録物名	Journal of the American Heart Association
巻(号)	12(15)
ページ	e029618
刊行年月	2023-08-01
言語	英語
ハンドルURL	https://hdl.handle.net/11094/92491
eISSN	20479980
関連情報	PMID 37489755
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1161/JAHA.123.029618
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Journal of the American Heart Association. 2023, 12(15), p. e029618
DC.title	Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study
DC.creator	Gon, Yasufumi
	Sakaguchi, Manabu
	Yamagami, Hiroshi
	Abe, Soichiro
	Hashimoto, Hiroyuki
	Ohara, Nobuyuki
	Takahashi, Daisuke
	Abe, Yuko
	Takahashi, Tsutomu
	Kitano, Takaya
	Okazaki, Shuhei
	Todo, Kenichi
	Sasaki, Tsutomu
	Hattori, Satoshi
	Mochizuki, Hideki
DC.publisher	American Heart Association Inc.
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2023-08-01
DC.identifier	https://doi.org/10.1161/JAHA.123.029618
DC.subject	active cancer
	cryptogenic stroke
	D-dimer
	distant metastasis
	ischemic stroke
DC.description	Gon Y., Sakaguchi M., Yamagami H., et al. Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study. Journal of the American Heart Association 12, e029618 (2023); https://doi.org/10.1161/JAHA.123.029618.
DCTERMS.abstract	BACKGROUND: Limited data exist on the prognostic factors for patients with ischemic stroke and active cancer. METHODS AND RESULTS: We conducted a prospective, multicenter, observational study in Japan, including patients with acute ischemic stroke and active cancer, to investigate the prognostic factors. We followed up the patients for 1 year after stroke onset. The patients were divided into 2 groups according to cryptogenic stroke and known causes (small-vessel occlusion, large-artery atherosclerosis, cardioembolism, and other determined cause), and survival was compared. The hazard ratios (HRs) and 95% CIs for mortality were calculated using Cox regression models. We identified 135 eligible patients (39% women; median age, 75 years). Of these patients, 51% had distant metastasis. A total of 65 (48%) and 70 (52%) patients had cryptogenic stroke and known causes, respectively. Patients with cryptogenic stroke had significantly shorter survival than those with known causes (HR [95% CI], 3.11 [1.82–5.32]). The multivariable Cox regression analysis revealed that distant metastasis, plasma D-dimer levels, venous thromboembolism (either deep venous thrombosis or pulmonary embolism) complications at stroke onset were independent predictors of mortality after adjusting for potential confounders. Cryptogenic stroke was associated with prognosis in univariable analysis but was not significant in multivariable analysis. The plasma D-dimer levels stratified the prognosis of patients with ischemic stroke and active cancer. CONCLUSIONS: The prognosis of patients with acute ischemic stroke and active cancer varied considerably depending on stroke mechanism, distant metastasis, and coagulation abnormalities. The present study confirmed that coagulation abnormalities were crucial in determining the prognosis of such patients.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	92491
citation_title	Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study
citation_author	Gon, Yasufumi
	Sakaguchi, Manabu
	Yamagami, Hiroshi
	Abe, Soichiro
	Hashimoto, Hiroyuki
	Ohara, Nobuyuki
	Takahashi, Daisuke
	Abe, Yuko
	Takahashi, Tsutomu
	Kitano, Takaya
	Okazaki, Shuhei
	Todo, Kenichi
	Sasaki, Tsutomu
	Hattori, Satoshi
	Mochizuki, Hideki
citation_publisher	American Heart Association Inc.
citation_language	英語
citation_date	2023-08-01
citation_journal_title	Journal of the American Heart Association
citation_volume	12
citation_issue	15
citation_firstpage	e029618
citation_doi	https://doi.org/10.1161/JAHA.123.029618
citation_pmid	37489755
citation_public_url	https://hdl.handle.net/11094/92491

Predictors of Survival in Patients With Ischemic Stroke and Active Cancer: A Prospective, Multicenter, Observational Study

閲覧可能ファイル

論文情報

論文詳細を表示