Abstract TP225: Prevalence and Impact of Intravascular Thrombosis in Patients With Cancer-Associated Stroke

Abstract

Background: Increased risk of acute ischemic stroke is observed among cancer patients. Hypercoagulability is commonly observed in cancer-associated stroke, and is thus considered as a possible mechanism. In this study, we aimed to demonstrate intravascular thrombosis and its clinical impact in patients with cancer-associated stroke. Methods: We enrolled consecutive patients with embolic stroke of unknown source (ESUS) with or without active cancer in Samsung Medical Center from August 2014 to March 2018. We evaluated the presence of intravascular thrombosis, i.e. intravenous and intra-arterial thrombosis, by investigating the presence of deep vein thrombosis (DVT), microembolic signal (MES) and coagulation abnormalities in all patients. Infarct volumes on diffusion-weighted imaging and death dates were also collected. Results: Of 142 patients screened, 118 were included in this study (cancer group, n=37; non-cancer group, n=81). Cancer group had a higher prevalence of intravascular thrombosis compared to non-cancer group (62.2% vs. 19.8%, p <0.001). In patients with cancer-associated stroke, only intravenous thrombosis was associated with higher infarct volume (Beta = 13.14, 95% CI = 1.62 - 24.66, p = 0.028). Both intravenous and intra-arterial thrombosis were independently associated with poor survival (multivariable HR = 11.55, 95% CI = 1.82 - 73.41, p = 0.010 and multivariable HR = 6.45, 95% CI = 1.28 - 32.40, p = 0.024, respectively). Conclusion: Our study results provide evidences of increased intravascular thrombosis and their clinical impact in patients with cancer-associated stroke. Our findings may enhance the understanding of cancer-associated stroke and risk stratification of patients.