Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke

Shinji Ito, Akihiro Ueda, Kenichiro Murate, Seiko Hirota, Takao Fukui, Tomomasa Ishikawa, Sayuri Shima, Chika Hikichi, Yasuaki Mizutani, Madoka Kizawa, Kunihiko Asakura, Tatsuro Mutoh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective Acute multifocal embolic infarction (AMEI) is conventionally caused by etiologies such as cardioembolism due to atrial fibrillation (Af), but can also be caused by serious underlying diseases such as cancer. We characterized cancer-related AMEI and identified useful indicators for cancer-associated strokes. Methods A retrospective analysis was performed on 35 patients with Af-related AMEI and 35 patients with cancer-related AMEI selected from 1235 consecutive patients with acute infarcts. All patients received diffusion-weighted magnetic resonance (MR) imaging. Cerebral MR angiography, carotid and cardiac ultrasonography, electrocardiogram-monitoring and whole body computed tomography were also performed on these patients. D-dimer levels were evaluated on admission, and were measured during the sub-acute phase in 19 of the patients with Af and 27 of the patients with cancer. Results Acute phase D-dimer levels were significantly higher in patients with cancer than in patients with Af alone. The cut-off D-dimer value to identify cancer-associated infarcts was 2.0 μg/mL. D-dimer levels during the sub-acute phase remained elevated in the cancer patients. Conclusions We may differentiate cancer-associated AMEI from Af using a D-dimer level ≥ 2.0 μg/mL, which does not decrease during the sub-acute phase.

Original languageEnglish
Pages (from-to)344-348
Number of pages5
JournalJournal of the Neurological Sciences
Volume368
DOIs
Publication statusPublished - 15-09-2016

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Atrial Fibrillation
Stroke
Infarction
Neoplasms
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Magnetic Resonance Angiography
Ultrasonography
Electrocardiography
Tomography
fibrin fragment D

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Ito, Shinji ; Ueda, Akihiro ; Murate, Kenichiro ; Hirota, Seiko ; Fukui, Takao ; Ishikawa, Tomomasa ; Shima, Sayuri ; Hikichi, Chika ; Mizutani, Yasuaki ; Kizawa, Madoka ; Asakura, Kunihiko ; Mutoh, Tatsuro. / Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke. In: Journal of the Neurological Sciences. 2016 ; Vol. 368. pp. 344-348.
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title = "Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke",
abstract = "Objective Acute multifocal embolic infarction (AMEI) is conventionally caused by etiologies such as cardioembolism due to atrial fibrillation (Af), but can also be caused by serious underlying diseases such as cancer. We characterized cancer-related AMEI and identified useful indicators for cancer-associated strokes. Methods A retrospective analysis was performed on 35 patients with Af-related AMEI and 35 patients with cancer-related AMEI selected from 1235 consecutive patients with acute infarcts. All patients received diffusion-weighted magnetic resonance (MR) imaging. Cerebral MR angiography, carotid and cardiac ultrasonography, electrocardiogram-monitoring and whole body computed tomography were also performed on these patients. D-dimer levels were evaluated on admission, and were measured during the sub-acute phase in 19 of the patients with Af and 27 of the patients with cancer. Results Acute phase D-dimer levels were significantly higher in patients with cancer than in patients with Af alone. The cut-off D-dimer value to identify cancer-associated infarcts was 2.0 μg/mL. D-dimer levels during the sub-acute phase remained elevated in the cancer patients. Conclusions We may differentiate cancer-associated AMEI from Af using a D-dimer level ≥ 2.0 μg/mL, which does not decrease during the sub-acute phase.",
author = "Shinji Ito and Akihiro Ueda and Kenichiro Murate and Seiko Hirota and Takao Fukui and Tomomasa Ishikawa and Sayuri Shima and Chika Hikichi and Yasuaki Mizutani and Madoka Kizawa and Kunihiko Asakura and Tatsuro Mutoh",
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Ito, S, Ueda, A, Murate, K, Hirota, S, Fukui, T, Ishikawa, T, Shima, S, Hikichi, C, Mizutani, Y, Kizawa, M, Asakura, K & Mutoh, T 2016, 'Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke', Journal of the Neurological Sciences, vol. 368, pp. 344-348. https://doi.org/10.1016/j.jns.2016.07.054

Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke. / Ito, Shinji; Ueda, Akihiro; Murate, Kenichiro; Hirota, Seiko; Fukui, Takao; Ishikawa, Tomomasa; Shima, Sayuri; Hikichi, Chika; Mizutani, Yasuaki; Kizawa, Madoka; Asakura, Kunihiko; Mutoh, Tatsuro.

In: Journal of the Neurological Sciences, Vol. 368, 15.09.2016, p. 344-348.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Differentiation of cancer from atrial fibrillation in patients with acute multifocal stroke

AU - Ito, Shinji

AU - Ueda, Akihiro

AU - Murate, Kenichiro

AU - Hirota, Seiko

AU - Fukui, Takao

AU - Ishikawa, Tomomasa

AU - Shima, Sayuri

AU - Hikichi, Chika

AU - Mizutani, Yasuaki

AU - Kizawa, Madoka

AU - Asakura, Kunihiko

AU - Mutoh, Tatsuro

PY - 2016/9/15

Y1 - 2016/9/15

N2 - Objective Acute multifocal embolic infarction (AMEI) is conventionally caused by etiologies such as cardioembolism due to atrial fibrillation (Af), but can also be caused by serious underlying diseases such as cancer. We characterized cancer-related AMEI and identified useful indicators for cancer-associated strokes. Methods A retrospective analysis was performed on 35 patients with Af-related AMEI and 35 patients with cancer-related AMEI selected from 1235 consecutive patients with acute infarcts. All patients received diffusion-weighted magnetic resonance (MR) imaging. Cerebral MR angiography, carotid and cardiac ultrasonography, electrocardiogram-monitoring and whole body computed tomography were also performed on these patients. D-dimer levels were evaluated on admission, and were measured during the sub-acute phase in 19 of the patients with Af and 27 of the patients with cancer. Results Acute phase D-dimer levels were significantly higher in patients with cancer than in patients with Af alone. The cut-off D-dimer value to identify cancer-associated infarcts was 2.0 μg/mL. D-dimer levels during the sub-acute phase remained elevated in the cancer patients. Conclusions We may differentiate cancer-associated AMEI from Af using a D-dimer level ≥ 2.0 μg/mL, which does not decrease during the sub-acute phase.

AB - Objective Acute multifocal embolic infarction (AMEI) is conventionally caused by etiologies such as cardioembolism due to atrial fibrillation (Af), but can also be caused by serious underlying diseases such as cancer. We characterized cancer-related AMEI and identified useful indicators for cancer-associated strokes. Methods A retrospective analysis was performed on 35 patients with Af-related AMEI and 35 patients with cancer-related AMEI selected from 1235 consecutive patients with acute infarcts. All patients received diffusion-weighted magnetic resonance (MR) imaging. Cerebral MR angiography, carotid and cardiac ultrasonography, electrocardiogram-monitoring and whole body computed tomography were also performed on these patients. D-dimer levels were evaluated on admission, and were measured during the sub-acute phase in 19 of the patients with Af and 27 of the patients with cancer. Results Acute phase D-dimer levels were significantly higher in patients with cancer than in patients with Af alone. The cut-off D-dimer value to identify cancer-associated infarcts was 2.0 μg/mL. D-dimer levels during the sub-acute phase remained elevated in the cancer patients. Conclusions We may differentiate cancer-associated AMEI from Af using a D-dimer level ≥ 2.0 μg/mL, which does not decrease during the sub-acute phase.

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