The 10th Annual Meeting of the European Society of Neurology (EAN) 2024 was held in Helsinki, the capital of Finland, from June 29 to July 2 local time. Neurology experts from around the globe come together to share and discuss the latest research findings. In the Late Breaking News session of this conference, research from Moritz Kielkopf in Switzerland reveals the impact of different antithrombotic drugs in the secondary prevention of cancer-related stroke.
The author of this article is the EAN reporting team of Yimaitong
Yimaitong collated the report, please do not reprint without authorization.
Overview of the study
Patients with acute ischemic stroke (AIS) with active cancer are common (about 10% of all AIS), and these patients are at high risk of AIS recurrence and death. Although presumed paraneoplastic coagulopathy is often preferred to anticoagulation, the optimal antithrombotic strategy in this population remains undetermined. This study aims to evaluate the relevance of anticoagulation versus anti-aggregation as secondary prevention in patients with AIS and active cancer.
Findings:
Of the 5012 patients with AIS, 135 had patients with active cancer. The anticoagulation group (n = 58, 66%) had a higher one-year mortality rate than the anti-aggregation group (n = 77, 33%). In adjusted analysis, anticoagulation was not associated with lower mortality compared with anti-aggregation therapy at one year (adjusted hazard ratio [aHR] 0.76; 95% CI 0.36–1.63) and long-term follow-up (aHR 1.29; 95%-CI 0.63–2.47). At long-term follow-up, the anticoagulation group (8.6%) and the anti-aggregation group (7.8%; p = 1.00).
Figure 1. Long-term survival curves in patients with AIS cancer who received anti-aggregation and anticoagulation therapy as secondary prevention showed higher mortality in patients treated with anti-aggregation therapy (red) compared to those who received anti-aggregation therapy (blue).
Figure 2. Association of one-year mortality after AIS with secondary prophylaxis and use of antithrombotic drugs and other covariates at hospital discharge. In the adjusted analysis, the primary outcome (mortality at one year after AIS) was not relevant
Conclusions of the study
Patients with active cancer AIS receiving anticoagulant therapy show more signs of paraneoplastic coagulopathy and metastatic cancer. In the unadjusted model, this indication bias resulted in higher mortality in patients on anticoagulation. However, after adjustment, there was no difference in results between the two groups.
医脉通编译自：M. Kielkopf, S. Venzin, J. Göcmen. et al. Outcomes of cancer- related strokes according to antithrombotic drug used for secondary prevention. EAN 2024.OPR-123.
Disclaimer: This platform aims to deliver more medical information to healthcare professionals. The content published on this platform should not be used as a substitute for professional medical guidance in any way, nor should it be regarded as diagnosis and treatment advice. If such information is used for purposes other than understanding medical information, the platform does not assume relevant responsibilities. This platform does not mean that it agrees with its descriptions and views on the published content. If copyright issues are involved, please contact us, and we will deal with it as soon as possible.
Yimaitong is a professional online doctor platform, and the mission of the platform is to "sense the pulse of the world's medicine and help China's clinical decision-making". Yimaitong has a series of products such as "Clinical Guidelines", "Medication Reference", "Medical Literature King", "Yizhiyuan", "eYantong" and "ePulse", which fully meet the needs of medical workers in clinical decision-making, obtaining new knowledge and improving scientific research efficiency.