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Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study

BACKGROUND: Cancer patients are at risk of thromboembolism. However, studies investigating the relationship between ovarian cancer and ischemic stroke are lacking. The objectives of this study were to assess the association between ovarian cancer and ischemic stroke, and to determine the predictive...

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Autores principales: Kuan, Ai-Seon, Teng, Chung-Jen, Wu, Hua-Hsi, Su, Vincent Yi-Fong, Chen, Yung-Tai, Chien, Sheng-Hsuan, Yeh, Chiu-Mei, Hu, Li-Yu, Chen, Tzeng-Ji, Tzeng, Cheng-Hwai, Liu, Chia-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022213/
https://www.ncbi.nlm.nih.gov/pubmed/24661584
http://dx.doi.org/10.1186/1741-7015-12-53
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author Kuan, Ai-Seon
Teng, Chung-Jen
Wu, Hua-Hsi
Su, Vincent Yi-Fong
Chen, Yung-Tai
Chien, Sheng-Hsuan
Yeh, Chiu-Mei
Hu, Li-Yu
Chen, Tzeng-Ji
Tzeng, Cheng-Hwai
Liu, Chia-Jen
author_facet Kuan, Ai-Seon
Teng, Chung-Jen
Wu, Hua-Hsi
Su, Vincent Yi-Fong
Chen, Yung-Tai
Chien, Sheng-Hsuan
Yeh, Chiu-Mei
Hu, Li-Yu
Chen, Tzeng-Ji
Tzeng, Cheng-Hwai
Liu, Chia-Jen
author_sort Kuan, Ai-Seon
collection PubMed
description BACKGROUND: Cancer patients are at risk of thromboembolism. However, studies investigating the relationship between ovarian cancer and ischemic stroke are lacking. The objectives of this study were to assess the association between ovarian cancer and ischemic stroke, and to determine the predictive risk factors. METHODS: Ovarian cancer patients aged 20 years and older without antecedent cerebrovascular events and who were followed up for more than 1 year between 1 January 2003 and 31 December 2011 were recruited from the Taiwan National Health Insurance database. Hazard ratios (HRs) of stroke risk for ovarian cancer patients compared with an age- and comorbidity-matched cohort were calculated by Cox proportional regression analysis. The difference in cumulative ischemic stroke incidence between ovarian cancer patients and the matched cohort was analyzed with the Kaplan-Meier method and tested with the log-rank test. RESULTS: Each cohort (ovarian cancer and matched cohort) consisted of 8,810 individuals, with a median age of 49 years. After a median follow-up of 2.68 and 3.85 years, respectively, the ischemic stroke incidence was 1.38-fold higher in the ovarian cancer cohort than in the comparison cohort (9.4 versus 6.8 per 1,000 person-years), with an age- and comorbidity-adjusted HR of 1.49 (P <0.001). The ischemic stroke risk imposed by ovarian cancer was more prominent in patients under 50 years old (HR 2.28; P <0.001) compared with patients 50 years and older (HR 1.33; P = 0.005). Significant risk factors predicting stroke development were age 50 years and older (HR 2.21; P <0.001), hypertension (HR 1.84; P <0.001), diabetes mellitus (HR 1.71; P <0.001), and treatment with chemotherapy (HR 1.45; P = 0.017), especially platinum-based regimens. CONCLUSIONS: Ovarian cancer patients were at an increased risk of developing ischemic stroke. Age, hypertension, diabetes, and chemotherapy treatment were independent risk factors.
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spelling pubmed-40222132014-05-16 Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study Kuan, Ai-Seon Teng, Chung-Jen Wu, Hua-Hsi Su, Vincent Yi-Fong Chen, Yung-Tai Chien, Sheng-Hsuan Yeh, Chiu-Mei Hu, Li-Yu Chen, Tzeng-Ji Tzeng, Cheng-Hwai Liu, Chia-Jen BMC Med Research Article BACKGROUND: Cancer patients are at risk of thromboembolism. However, studies investigating the relationship between ovarian cancer and ischemic stroke are lacking. The objectives of this study were to assess the association between ovarian cancer and ischemic stroke, and to determine the predictive risk factors. METHODS: Ovarian cancer patients aged 20 years and older without antecedent cerebrovascular events and who were followed up for more than 1 year between 1 January 2003 and 31 December 2011 were recruited from the Taiwan National Health Insurance database. Hazard ratios (HRs) of stroke risk for ovarian cancer patients compared with an age- and comorbidity-matched cohort were calculated by Cox proportional regression analysis. The difference in cumulative ischemic stroke incidence between ovarian cancer patients and the matched cohort was analyzed with the Kaplan-Meier method and tested with the log-rank test. RESULTS: Each cohort (ovarian cancer and matched cohort) consisted of 8,810 individuals, with a median age of 49 years. After a median follow-up of 2.68 and 3.85 years, respectively, the ischemic stroke incidence was 1.38-fold higher in the ovarian cancer cohort than in the comparison cohort (9.4 versus 6.8 per 1,000 person-years), with an age- and comorbidity-adjusted HR of 1.49 (P <0.001). The ischemic stroke risk imposed by ovarian cancer was more prominent in patients under 50 years old (HR 2.28; P <0.001) compared with patients 50 years and older (HR 1.33; P = 0.005). Significant risk factors predicting stroke development were age 50 years and older (HR 2.21; P <0.001), hypertension (HR 1.84; P <0.001), diabetes mellitus (HR 1.71; P <0.001), and treatment with chemotherapy (HR 1.45; P = 0.017), especially platinum-based regimens. CONCLUSIONS: Ovarian cancer patients were at an increased risk of developing ischemic stroke. Age, hypertension, diabetes, and chemotherapy treatment were independent risk factors. BioMed Central 2014-03-25 /pmc/articles/PMC4022213/ /pubmed/24661584 http://dx.doi.org/10.1186/1741-7015-12-53 Text en Copyright © 2014 Kuan et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kuan, Ai-Seon
Teng, Chung-Jen
Wu, Hua-Hsi
Su, Vincent Yi-Fong
Chen, Yung-Tai
Chien, Sheng-Hsuan
Yeh, Chiu-Mei
Hu, Li-Yu
Chen, Tzeng-Ji
Tzeng, Cheng-Hwai
Liu, Chia-Jen
Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title_full Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title_fullStr Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title_full_unstemmed Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title_short Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
title_sort risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022213/
https://www.ncbi.nlm.nih.gov/pubmed/24661584
http://dx.doi.org/10.1186/1741-7015-12-53
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