According to research results presented during the American Stroke Association?s International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians held January 24?26, 2018 in the Los Angeles Convention Center, Los Angeles, CA, cancer patients are, following a stroke, one-third less likely to receive standard clot-busting medication as patients without a malignancy.
Photo 1.0: Babak B. Navi M.D. Babak B. Navi M.D., Weill Cornell Medicine, New York City, New York.?Cancer patients frequently have strokes, which can occur due to traditional risk factors or from risks associated with cancer, such as blood that clots more easily, or its treatment. Over time, the use of both clot-dissolving drugs and procedures that mechanically remove clots following stroke have increased.
In the current study, Babak B. Navi MD., and a team of researchers from?Weill Cornell Medicine,?New York City, New York,?sought to determine whether these approaches increased as much in stroke patients with cancer.
In a national sample of patients, taken from the National Inpatient Sample from 1998 to 2013 on patients hospitalized for an acute ischemic stroke, which excluded patients with brain cancer, the researchers found that the use of clot-busting medication rose from 0.01% in 1998 to 4.23% in 2013 in cancer patients with stroke, but its use remains about one-third lower than in patients without cancer.
However, the researchers also found that, in patients without cancer, during the same time period, medication use increased from 0.02% to 6.38%.
The use of newer procedures to mechanically remove clots rose from 0.05% in 2006 to 1.073 in 2013 in cancer patients with stroke, and is similar to its use in patients without cancer.
The study was funded by the National Institute of Neurological Disorders and Stroke.
Self-fulfilling prophecy
An unrelated study by Navi et al, published in the?Journal of the American College of Cardiology, showed that patients newly diagnosed with cancer?found an increased risk for a stroke or heart attack among patients newly diagnosed with cancer. That study, which?identified 279,719 pairs of patients with cancer and matched control patients, found that 4.7% of Medicare cancer patients had an arterial thromboembolism within six months of their diagnosis (95% confidence interval [CI]: 4.6% to 4.8%). In contrast, only to 2.2% of Medicare patients who did not have cancer?(95% CI: 2.1% to 2.2%) | hazard ratio [HR]: 2.2; 95% CI: 2.1 to 2.3.
While the authors of the study were mot able to explain why cancer patients are less likely to get clot-busting medication. ?However, Navi hypotesized that cancer patients may get these types of drugs less often because they may have been on blood thinners or have a low blood platelet count.[1]
Navi also believes another hypothesis tot be acceptable. “Some cancer patients may not get these drugs because they aren?t expected to do well. ?But this clearly causes a self-fulfilling prophecy,? he concluded.
Last Editorial Review: January 26, 2018
Featured Image:?Brain Scan. Courtesy: ? 2010 – 2017 Fotolia. Used with permission. Photo 1.0.?Babak B. Navi MD.?Courtesy: ? 2010 – 2017 ?| Weill Cornell Medicine,?New York City, New York.
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