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. 2023;13(1):75-82.
doi: 10.1159/000534267. Epub 2023 Sep 29.

Non-Hypertensives and Those with Normal Cholesterol Are More Likely to Have Concomitant Cancer amongst Patients with Ischemic Stroke: A Retrospective Cross-Sectional Registry-Based Study

Kendra Jing Ying Tang  1 , Seyed Ehsan Saffari  2 , Kaavya Narasimhalu  1   3 , Kian Kheng Queck  4 , Deidre Anne De Silva  1   3
Affiliations

Non-Hypertensives and Those with Normal Cholesterol Are More Likely to Have Concomitant Cancer amongst Patients with Ischemic Stroke: A Retrospective Cross-Sectional Registry-Based Study

Kendra Jing Ying Tang et al. Cerebrovasc Dis Extra. 2023.

Abstract

Introduction: Patients with cancer are known to have an increased risk of ischemic stroke (IS) around the time of their diagnosis. However, there is a paucity of data in Asian populations, and as such, we aimed to determine cancer incidence rates and patterns in Asian IS patients as well as investigate the differences in vascular risk profile of IS patients with and without concomitant cancer.

Methods: We conducted a retrospective cross-sectional study using data from the Singapore Stroke and Cancer registries. We defined cases as patients with IS and a cancer diagnosis 2 years before or after the index IS. Cancer incidence was determined using the same direct age-standardization method performed for the Singapore general population in the 2015 Singapore cancer report. Multivariable logistic regression was used to analyze differences in vascular risk factors.

Results: Among 21,068 IS patients (mean age, 67.9 ± 13.3 years), 6.3% (1,330) were found to have concomitant cancer; 4.4% (935) had prior cancer while 1.8% (395) had cancer diagnoses within 2 years following IS. The cancer incidence among IS patients was 3,393 (95% confidence interval [CI], 1,937-4,849) per 100,000 person-years compared to 219-231 per 100,000 person-years in the general population. Older age (odds ratio [OR], 1.02 [95% CI, 1.01-1.02] per year), males (OR, 1.25 [95% CI, 1.11-1.41), Chinese ethnicity (OR, 1.61 [95% CI, 1.37-1.89]) and a lower prevalence of hypertension (OR, 0.84 [95% CI, 0.73-0.97)]), and hyperlipidemia (OR, 0.53 [95% CI, 0.45-0.62]) were independently associated with cancer-related IS.

Conclusions: The age-standardized cancer incidence was 15 times higher in IS patients than the general population. IS patients with concomitant cancer were older and had a lower prevalence of vascular risk factors.

Keywords: Cancer; Incidence; Ischemic stroke; Occult malignancy; Registries; Risk factors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Consolidated Standards of Reporting Trials (CONSORT) diagram of stages of patient screening. IS indicates ischemic stroke.
See this image and copyright information in PMC

References

    1. Graus F, Rogers LR, Posner JB. Cerebrovascular complications in patients with cancer. Medicine. 1985 Jan;64(1):16–35. 10.1097/00005792-198501000-00002. - DOI - PubMed
    1. Stefan O, Vera N, Otto B, Heinz L, Wolfgang G. Stroke in cancer patients: a risk factor analysis. J Neurooncol. 2009 Sep 1;94(2):221–6. 10.1007/s11060-009-9818-3. - DOI - PubMed
    1. Lindvig K, Moller H, Mosbech J, Jensen OM. The pattern of cancer in a large cohort of stroke patients. Int J Epidemiol. 1990 Sep;19(3):498–504. 10.1093/ije/19.3.498. - DOI - PubMed
    1. Turner M, Murchie P, Derby S, Ong AY, Walji L, McLernon D, et al. . Is stroke incidence increased in survivors of adult cancers? A systematic review and meta-analysis. J Cancer Surviv. 2022 Dec;16(6):1414–48. 10.1007/s11764-021-01122-7. - DOI - PMC - PubMed
    1. Taccone FS, Jeangette SM, Blecic SA. First-ever stroke as initial presentation of systemic cancer. J Stroke Cerebrovasc Dis. 2008 Jul–Aug;17(4):169–74. 10.1016/j.jstrokecerebrovasdis.2008.01.007. - DOI - PubMed