[P02.082] Outcomes of Patients with Malignancy Treated with Thrombolytics
Ramy El Khoury, Miriam M. Morales, Oleg Chernyshev, Anitha Abraham, M. Rick Sline, Indrani Acosta, Vivek Misra, Andrew Barreto, Sean Savitz, Kachikwu Illoh, James Grotta, Nicole R. Gonzales, Bellaire, TX, Mc Lean, VA, Houston, TX
OBJECTIVE: Treating patients with a history of cancer for ischemic strokes with thrombolytics may not alter patient's outcome. BACKGROUND: Very limited literature discusses the outcome of patients with malignancy treated with thrombolytics for ischemic stroke. The purpose of our research is to describe our experience in treating patients who have malignancy with thrombolysis. DESIGN/METHODS: We conducted a retrospective case-control study comparing the outcomes of patients receiving thrombolysis with a history of or active cancer (cancer positive, CP) compared with a control group (cancer negative, CN) matched for age and baseline NIHSS. Primary outcome measure was symptomatic intracerebral hemorrhage (sICH). Secondary outcome measures included good outcome (discharge modified Rankin Scale (mRS) <3), and good discharge disposition (discharge home or in-patient rehabilitation). RESULTS: From 2003-2008, 679 patients were treated with thrombolytics (IV, IV/IA, or IA only). Of these, 60 patients were CP with a mean age 73 (SD, 13) years and 120 CN patients were matched for age and baseline NIHSS. Baseline median NIHSS was 12 in both groups with similar ranges (p=0.835). There were no significant differences among baseline characteristics between the two groups. The most common malignancies were prostate 27% and breast 22%. There was no significant difference among 24 hour post-tPA NIHSS, good outcomes, length of stay, sICH, or good disposition. CONCLUSIONS/RELEVANCE: Our data demonstrates that patients with malignancy (or a history of) who receive thrombolysis have outcomes similar to CN patients and do not appear to be at increased risk of sICH. It also suggests that the presence or history of malignancy should not preclude thrombolysis if the patient is otherwise a thrombolytic candidate.
Category - Cerebrovascular Disease - Acute Stroke Therapy
Tuesday, April 28, 2009 11:30 AM
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