Original ArticleRisk of Thrombolytic Therapy for Acute Ischemic Stroke in Patients With Current Malignancy
Section snippets
Patient Selection
This study was a retrospective analysis of data from a prospectively identified cohort of AIS patients collected at a single large tertiary care center. Consecutive AIS patients admitted between January 2003 and December 2006 (n = 2148) were identified by screening hospital admission logs. Patients who received IV tPA within 3 hours of stroke onset (started either at our center or transferred to us after receiving tPA) or intra-arterial thrombolysis (IAT) or mechanical clot retrieval were included
Results
Of the 2148 AIS patients in this study, 308 (14.3%) were treated with thrombolytic therapy. Of these 308 patients, 210 (68%) received IV tPA without IAT, 41 (13%) eceived IV tPA plus IAT, and 57 (18%) received IAT only. Forty-four patients (14%) had either CM (n = 18) or RM (n = 26). Of these 44 malignancies, breast (n = 9; 21%) and lung (n = 9; 21%) were the most common, followed by colon (n = 8; 18%), hematologic (n = 5; 11%), prostate (n = 4; 9%), skin (n = 4; 9%), and all other types (n = 5; 11%).
Among the
Discussion
In this study, we found an association between CM and increased in-hospital mortality after thrombolytic therapy for AIS in univariate analysis, but this association did not persist when adjusting for other known factors associated with mortality. The mortality in AIS patients with CM did not appear to be due to increased rates of symptomatic ICH or other manifestations of hemostatic dysfunction, but rather was linked to withdrawal of care due to comorbid medical conditions (including the
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The authors have no conflicts of interest to disclose.