Cancer can increase the risk of stroke due to multiple causes especially during the first 3-6 months after diagnosis for
lung, pancreatic, colorectal, breast, prostate cancers or
with diagnosed cancer in the nervous system or leukaemia.
The occurrence of metastasis is associated with an increased
risk of haemorrhagic/ischaemic stroke. In patients with
cancer in the nervous system, colon, rectum, urinary bladder
or leukaemia, an increased risk of ischemic stroke has been
found even during long-term observation as for women
with breast cancer. Radiotherapy has been reported to
be a risk factor for stroke as well as for myocardial infarction
(MI), whereas treatment with tamoxifen has been reported
to increase the risk of stroke but to decrease the
risk of MI.
Charturwedi et al. declared that the identified ischaemic
strokes among cancer patients were low and that the rate of recurrent ischaemic events, which occurred in 6% of cancer
patients during a mean observation of 9 months, was not
higher than the results from different stroke studies reported.
However, in a Chinese stroke study past cancer was
shown by Cox regression analysis to be a predictor of recurrent
stroke as well as cardiovascular mortality during longterm
follow-up. The main purposes of this retrospective study
were to determine whether patients admitted due to transient
ischaemic attack (TIA) or different subgroups of stroke
with a diagnosis of malignant cancer (International Classification
of Disease (ICD), ICD-10: C00-C97) either before and/or
after admission had different risks of recurrent stroke and MI
annually compared to patients without cancer.
This study consists of a cohort of 549 patients who had been
hospitalized in the Stroke Unit or on the general ward of the
Department of Neurology, University Hospital Linköping in
1986 and retro/prospectively followed up until Feb. 2011.
The definitions of risk factors have been reported previously. Cause of death was based on the underlying cause,
defined by the World Health Organization (WHO) as the disorder
that began the chain of events leading to death. Data
about types of cancer were obtained from the Swedish Cancer
Registry established in 1958 and with data to 2010, with permission from the National Board of Health and Welfare,
Stockholm, Sweden as well from journals and autopsy reports.
Patients with basal cell carcinoma were not included in this
report because basal cell carcinoma was not included in the
Swedish Cancer Registry until 2004. Stage of cancer or cancer
treatment was not reported.
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