Risk of ischemic stroke after cancer diagnosis: a population-based matched cohort study.

IF 5.5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis Pub Date : 2025-01-09 DOI:10.1016/j.jtha.2024.12.029

Deborah M Siegal, Joshua O Cerasuolo, Marc Carrier, Peter L Gross, Moira K Kapral, David Kirkwood, Ronda Lun, Michel Shamy, Rinku Sutradhar

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引用次数: 0

Abstract

Background: There are limited data regarding the association between cancer and ischemic stroke, particularly among individuals with previous stroke. Our objective was to measure and compare the risk of ischemic stroke in individuals with and without cancer.

Methods: Population-based matched cohort study in Ontario, Canada. Participants ≥18 years with a new diagnosis of cancer were matched (1:1) to cancer-free controls by age and sex in two separate matched cohorts based on the absence (Matched Cohort 1) or presence (Matched Cohort 2) of prior ischemic stroke. The primary outcome was the incidence of ischemic stroke. We calculated sub-distribution adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for ischemic stroke (death as a competing event).

Results: In Matched Cohort 1, the rate and risk of ischemic stroke were higher among 620,647 cancer patients versus 620,647 controls at 1.5 years (4.6/1000 person-years [95%CI 4.5-4.7] vs 3.5/1000 person-years [95%CI 3.4-3.6], aHR 1.40, 95%CI 1.34-1.47). In Matched Cohort 2, the rate and risk of ischemic stroke were similar among 13,924 cancer patients and 13,924 controls at 1.5 years (26.9/1000 person-years [95%CI 25.1-28.9] vs 22.0 /1000 person-years [95/%CI 20.7-23.4]; aHR 1.00, 95%CI 0.88-1.14). In both cohorts, the risk of ischemic stroke was lower in cancer patients versus controls from 1.5 to 5 years (aHR 0.72, 95%CI 0.69-0.74 and aHR 0.53, 95%CI 0.46-0.62).

Conclusions: Compared to cancer-free controls, the rate and risk of ischemic stroke were higher 1.5 years after cancer diagnosis in individuals without prior stroke and varied according to cancer site and stage.

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背景：关于癌症与缺血性脑卒中之间关系的数据有限，尤其是在既往有脑卒中的人群中。我们的目标是测量并比较癌症患者和非癌症患者发生缺血性中风的风险：方法：在加拿大安大略省开展基于人群的匹配队列研究。在两个独立的匹配队列中，年龄≥18 岁、新诊断为癌症的参与者与无癌症对照者按年龄和性别进行了匹配（1:1），匹配的依据是既往无缺血性中风（匹配队列 1）或既往有缺血性中风（匹配队列 2）。主要结果是缺血性中风的发病率。我们计算了缺血性中风（死亡为竞争事件）的亚分布调整危险比（aHR）和 95% 置信区间（CI）：在匹配队列 1 中，620 647 名癌症患者与 620 647 名对照组相比，1.5 年后缺血性中风的发生率和风险更高（4.6/1000 人年 [95%CI 4.5-4.7] vs 3.5/1000 人年 [95%CI 3.4-3.6]，aHR 1.40，95%CI 1.34-1.47）。在匹配队列 2 中，13924 名癌症患者和 13924 名对照者在 1.5 年时发生缺血性中风的比例和风险相似（26.9/1000 人-年 [95%CI 25.1-28.9] vs 22.0 /1000 人-年 [95/%CI 20.7-23.4]; aHR 1.00, 95%CI 0.88-1.14）。在两个队列中，癌症患者在1.5至5年内发生缺血性中风的风险均低于对照组（aHR 0.72，95%CI 0.69-0.74；aHR 0.53，95%CI 0.46-0.62）：结论：与未患癌症的对照组相比，既往未发生过中风的癌症患者在确诊癌症后 1.5 年发生缺血性中风的比例和风险较高，且因癌症部位和分期而异。

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来源期刊

Journal of Thrombosis and Haemostasis 医学-外周血管病

CiteScore

24.30

自引率

3.80%

发文量

321

审稿时长

1 months

期刊介绍： The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.