D-dimer >2.785 μg/ml and multiple infarcts ≥3 vascular territories are two characteristics of identifying cancer-associated ischemic stroke patients. (2nd November 2018)

• Record Type: Journal Article
• Authors: Wang, Jing-ye; Zhang, Gao-jia; Zhuo, Sheng-xia; Wang, Kai; Hu, Xiao-peng; Zhang, Hui; Qu, Lin-di
• Is Part Of: Neurological research. Volume 40:Number 11(2018)
• Page Start: 948
• Page End: 954
• Publication Date: 2018-11-02
• Subjects: Acute ischemic stroke -- acute multiple brain infarcts -- cancer -- cancer-associated ischemic stroke -- D-dimer value -- hypercoagulation; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1080/01616412.2018.1504179
• Languages: English
• ISSNs: 0161-6412

Abstract

ABSTRACT: Background : The patterns and mechanisms underlying stroke in cancer patients differ from those of the conventional etiology. In this study, we further investigated the characteristics distinguishing cancer-associated ischemic stroke (CAIS) and the relationship of D-dimer value with CAIS. Methods : Sixty-one acute ischemic stroke patients with cancer (cancer group) and 76 stroke patients without cancer (control group) were recruited. Cerebrovascular distribution was divided into 3 circulations and 23 vascular territories, and acute multiple brain infarcts (AMBIs) were defined as discrete MRI diffusion-weighted imaging (DWI) lesions in >1 vascular territory. Results : Cancer patients had higher average D-dimer and fibrinogen degradation product values, and fewer stroke risk factors. The numbers of infarct-affected vascular territories, AMBIs, and AMBIs in multiple circulations were significantly higher in the cancer group. Receiver operating characteristic analysis showed that the cutoff value of D-dimer was 2.785 μg/ml; and above features were particularly evident in cancer patients whose D-dimer values were >2.785 μg/ml, while those with D-dimer values ≤2.785 μg/ml were similar to controls. Conclusions : D-dimer >2.785 μg/ml may be an effective cutoff value and a sensitive index for identifying CAIS patients. AMBIs in ≥3 vascular territories and AMBIs in both the anterior and posterior circulations are two imaging characteristics of CAIS.