Outcome of Stroke Patients with Cancer and Nonbacterial Thrombotic Endocarditis

• Published in: Journal of stroke 2020, 22(2), 18, pp.245-253
• Main Authors: Yoo, Joonsang, Choi, Jin Kyo, Kim, Young Dae, Nam, Hyo Suk, Park, Hyungjong, Lee, Hye Sun, Heo, Ji Hoe
• Format: Article
• Language: English
• Subjects: metastasis; mortality; neoplasms; nonbacterial thrombotic endocarditis; Original; stroke; 신경과학
• ISSN: 2287-6391; 2287-6405
• DOI: 10.5853/jos.2020.00619

Background and Purpose Nonbacterial thrombotic endocarditis (NBTE) is a cause of stroke in cancer. However, clinical characteristics and outcomes in stroke patients with cancer-associated NBTE are not well known.Methods We included consecutive patients with stroke and active cancer over a 9-year period who underwent echocardiography. We retrospectively compared clinical characteristics and presence of metastasis between patients with NBTE, those with cryptogenic etiologies, and those with determined etiologies. We also investigated mortality and stroke events during the 6-month follow-up.Results Among the 245 patients, 20 had NBTE, 96 had cryptogenic etiologies, and 129 had determined etiologies. Metastasis was seen in all 20 patients (100%) with NBTE, 69.8% in patients with cryptogenic etiology, and 48.8% in patients with or determined etiology. During the 6-month follow-up, 127 patients (51.8%) developed stroke and/or died (death in 110 [44.9%] and stroke events in 55 [22.4%]). Patients with NBTE showed significantly higher mortality (80%) and stroke occurrence (50%) than those with cryptogenic etiologies (mortality 54.2%, stroke 25.0%, log-rank P=0.006) and determined etiologies (mortality 32.6%, stroke 16.3%, log-rank P