title: Safety of intravenous thrombolysis for acute ischaemic stroke including concomitant neoplastic disease sufferers - experience from Poland.
abstract: BACKGROUND
  Ischaemic stroke (IS), brain haemorrhage and cerebral venous thrombosis can occur as an early and late complication of cancer in the clinical course. Cancer patients are at increased risk for stroke from direct and indirect effects of their malignancy.
  
  
  OBJECTIVE
  The aim of our study was to evaluate the relationship between neoplastic disease and the long-term outcome, mortality and the presence of haemorrhagic complications in patients with acute IS treated with i.v. thrombolysis.
  
  
  METHODS
  We retrospectively evaluated the demographic and clinical data of 495 Caucasian patients with acute IS and 40 patients with IS and concomitant neoplastic disease who were consecutively treated from 2006 to 2013 in two experienced stroke centres.
  
  
  RESULTS
  In analysed group, there were 7.8% of patients with cancer [50.0% male, mean age 72.3 ± 9.3; National Institutes of Health Stroke Scale - 13 (range 9.5-17)]. Cancer was diagnosed before i.v.-thrombolysis in 28 (70.0%) patients. After 3 months of follow up, 60% of patients were independent (mRS 0-2) compared with the group of patients without cancer - 55% (p = 0.54), 17.5% died (18.4%; p = 0.89), 12.4% suffered haemorrhagic transformation (HT) (17.6%; p = 0.41) and 2.5% experienced SICH (4.4%; p = 0.56, respectively). Other clinical complications were not found. A multivariate analysis showed no impact of neoplastic disease on unfavourable outcomes [modified Rankin scale 3-6)] after 3 months (p = 0.15).
  
  
  CONCLUSIONS
  Intravenous thrombolysis performed in Caucasian stroke patients with past or current neoplastic diseases, but not in the course of chemo- and radiotherapy, can be a safe and effective method of treatment. In making decision on the thrombolytic treatment, the risk of bleeding complications and the life expectancy should be assessed.
authors.affiliation: Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Sobolewski
authors.affiliation: Department of Neurology and Stroke Unit, Saint Luke's Hospital in Końskie, Końskie, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Brola
authors.affiliation: Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Szczuchniak
authors.affiliation: Department of Neurology and Stroke Unit, Saint Luke's Hospital in Końskie, Końskie, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Fudala
authors.affiliation: Department of Neurology and Stroke Unit, Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Sobota
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011044:Poland; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000188:drug therapy
chemical_list: D005343:Fibrinolytic Agents