In her PhD thesis, Henriette Aurora Selvik shows that cancer rarely seems to cause stroke, and she suggests a new predictive model to find out when to screen ischemic stroke patients for cancer.
- More patients with ischemic stroke have prior cancer compared to the general population.
- Cancer-associated stroke is rare.
- A score comprising elevated D-dimer and smoking habits can predict active cancer in patients with ischemic stroke.
Thesis: Cancer-Associated Ischemic Stroke: The Bergen NORSTROKE Study
Candidate: Henriette Aurora Selvik
Time: May 25, 2018 at 12:30
Place: Univeristy of Bergen: BB-building, Auditorium 1
Link to university website (in Norwegian)
(1) 15.7 % of stroke patients had at least one prior diagnoses of cancer. The prevalence was significantly increased in all age groups when compared to the general population. The rate of cardioembolic strokes was higher in patients with prior cancer compared to other stroke patients.
Around 1500 stroke patients included in the NORSTROKE registry were included in Selvik’s studies.
(2) The occurrence of cancer in patients who have recently suffered an ischemic stroke is low. 4.3 % of the stroke patients with no history of cancer were diagnosed with cancer after stroke, of which less than half were diagnosed within the first year. Selvik and coworkers conclude than routine investigation for cancer seems unwarranted in acute ischemic stroke.
(3) By combining high plasma levels of D-dimer, low plasma levels of hemoglobin, previous or current smoking and undetermined stroke etiology, a predictive score of active cancer can be obtained for patients with ischemic stroke. The probability of active cancer is 53 % in the patients who fulfill all score points. The score can be used to evaluate which patients with ischemic stroke should be screened for cancer.
(1) Selvik, H. A., Thomassen, L., Logallo, N., & Næss, H. (2014). Prior cancer in patients with ischemic stroke: the Bergen NORSTROKE study. Journal of Stroke and Cerebrovascular Diseases, 23(5), 919-925.
(2) Selvik, H. A., Thomassen, L., Bjerkreim, A. T., & Næss, H. (2015). Cancer-associated stroke: the Bergen NORSTROKE study. Cerebrovascular diseases extra, 5(3), 107-113.
(3) Selvik, H. A., Bjerkreim, A. T., Thomassen, L., Waje-Andreassen, U., Naess, H., & Kvistad, C. E. (2018). When to Screen Ischaemic Stroke Patients for Cancer. Cerebrovascular Diseases, 45(1-2), 42-47.