title: The activity of malignancy may determine stroke pattern in cancer patients.
abstract: BACKGROUND
  It has been suggested that stroke in patients with cancer may differ from the conventional pattern. The aim of this study was to evaluate the burden of vascular risk factors, stroke etiology, and short-term outcome in patients with active and nonactive malignancy compared with patients without cancer.
  
  
  METHODS
  This is a prospective cohort study of consecutive acute stroke patients admitted to our department between September 2006 and September 2011. We distinguished between the following: (1) patients with active malignancy (AM, diagnosed not earlier than 12 months before stroke); (2) patients with nonactive malignancy (non-AM); and (3) cancer-free (CF) patients, used as a reference.
  
  
  RESULTS
  Pre-existing cancer was found in 90 of 1558 patients, including 41 (2.6%) cases with AM and 49 (3.1%) cases with non-AM. Compared with CF patients, AM patients less frequently had a history of previous stroke (2.4% versus 17.9%, P = .018) and more frequently experienced ischemic strokes of undetermined etiology (62.5% versus 38.3%, P = .002). Non-AM patients did not differ in the distribution of vascular risk factors but more often experienced stroke caused by small vessel occlusion (20.0% versus 8.0%, P = .004). Inflammatory blood markers were elevated especially in patients with AM. Short-term prognosis was similar across all groups.
  
  
  CONCLUSIONS
  Stroke pattern in patients with non-AM appears very similar to that observed in the CF patients. However, our findings support the thesis that cancer-specific prothrombotic mechanisms play an important role in stroke patients with AM, which may be related to active inflammatory and immune processes. Malignancy does not influence short-term prognosis of stroke.
authors: Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. Electronic address: akarlinska@ipin.edu.pl.
authors: Anna G
authors: AG
authors: Karlińska
authors: Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Grażyna
authors: G
authors: Gromadzka
authors: Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Michał A
authors: MA
authors: Karliński
authors: Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors: Anna
authors: A
authors: Członkowska
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors
keywords: Etiology; malignancy; outcome; prothrombotic; risk factors; stroke