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Cancer in Young Adults With Ischemic Stroke
- Aarnio, K. (author)
- Joensuu, H. (author)
- Haapaniemi, E. (author)
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- Melkas, S. (author)
- Kaste, M. (author)
- Putaala, J. (author)
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- (creator_code:org_t)
- Ovid Technologies (Wolters Kluwer Health), 2015
- 2015
- English.
- In: Stroke. - : Ovid Technologies (Wolters Kluwer Health). - 0039-2499 .- 1524-4628. ; 46:6
- Journal article (peer-reviewed)
Abstract
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- Background and Purpose-Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke. Methods-1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5-13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan-Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality. Results-One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0-9.5) years and from stroke to poststroke cancer was 6.7 (2.7-10.9) years. Poststroke cancer was associated with age >40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%-85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%-23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators. Conclusions-Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Keyword
- outcome
- MANIFESTATION
- ASSOCIATION
- PREVENTION
- MORTALITY
- REGISTRY
- THERAPY
- PATTERN
- EVENTS
- Clinical Neurology
- Peripheral Vascular Disease
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- ref (subject category)
- art (subject category)
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- Aarnio, K.
- Joensuu, H.
- Haapaniemi, E.
- Melkas, S.
- Kaste, M.
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- Putaala, J.
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- Stroke
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- University of Gothenburg
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