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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background and Purpose Nonbacterial thrombotic endocarditis (NBTE) is a cause of stroke in cancer. However, clinical characteristics and outcomes in stroke patients with cancer-associated NBTE are not well known. Methods We included consecutive patients with stroke and active cancer over a 9-year period who underwent echocardiography. We retrospectively compared clinical characteristics and presence of metastasis between patients with NBTE, those with cryptogenic etiologies, and those with determined etiologies. We also investigated mortality and stroke events during the 6-month follow-up. Results Among the 245 patients, 20 had NBTE, 96 had cryptogenic etiologies, and 129 had determined etiologies. Metastasis was seen in all 20 patients (100%) with NBTE, 69.8% in patients with cryptogenic etiology, and 48.8% in patients with or determined etiology. During the 6-month follow-up, 127 patients (51.8%) developed stroke and/or died (death in 110 [44.9%] and stroke events in 55 [22.4%]). Patients with NBTE showed significantly higher mortality (80%) and stroke occurrence (50%) than those with cryptogenic etiologies (mortality 54.2%, stroke 25.0%, log-rank P=0.006) and determined etiologies (mortality 32.6%, stroke 16.3%, log-rank P<0.001). In a multivariate Cox proportional hazard analysis, the presence of NBTE was independently associated with composite outcomes of mortality and stroke events (hazard ratio, 1.941; 95% confidence interval, 1.052 to 3.690). Conclusions NBTE should be suspected as a potential cause of stroke in patients with metastatic cancer. Patients with NBTE have a high risk of recurrent stroke and mortality. Future studies are necessary to determine strategies to reduce stroke recurrence in patients with NBTE.
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참고문헌 (31)
참고문헌 신청
Navi BB / 2017 / Risk of arterial thromboembolism in patients with cancer / J Am Coll Cardiol 70:926~938
김경섭 / 2017 / Histopathological Findings of Intracranial Thrombi in Nonbacterial Thrombotic Endocarditis / 대한뇌졸중학회지 19(3):367~369
Navi BB / 2018 / Ischemic stroke in cancer patients : a review of an underappreciated pathology / Ann Neurol 83:873~883
Oh Young Bang / 2020 / Cancer-Related Stroke: An Emerging Subtype of Ischemic Stroke with Unique Pathomechanisms / 대한뇌졸중학회지 22(1):1~10
Reagan TJ / 1974 / The thrombotic syndrome associated with carcinoma. A clinical and neuropathologic study / Arch Neurol 31:390~395
김경섭 / 2017 / Histopathological Findings of Intracranial Thrombi in Nonbacterial Thrombotic Endocarditis / 대한뇌졸중학회지 19(3):367~369
Navi BB / 2018 / Ischemic stroke in cancer patients : a review of an underappreciated pathology / Ann Neurol 83:873~883
Oh Young Bang / 2020 / Cancer-Related Stroke: An Emerging Subtype of Ischemic Stroke with Unique Pathomechanisms / 대한뇌졸중학회지 22(1):1~10
Reagan TJ / 1974 / The thrombotic syndrome associated with carcinoma. A clinical and neuropathologic study / Arch Neurol 31:390~395
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