PB0037 - Von Willebrand factor antigen levels predict poor outcomes in stroke patients with cancer: findings from the multicenter, prospective, observational SCAN study

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Tomohiro Kawano, MD, PhD

Assistant Professor
Department of Neurology, University of Osaka
Suita, Osaka, Japan

Co-Author(s)

YG

Yasufumi Gon

Assistant professor
Department of neurology, Osaka University graduate school of medicine
Suita, Osaka, Japan
MS

Manabu Sakaguchi

Manager
Department of Neurology, Osaka General Medical Center
Osaka, Osaka, Japan
HY

Hiroshi Yamagami

Manager
Department of Neurology, National Hospital Organization Osaka National Hospital
Osaka, Osaka, Japan
SA

Soichiro Abe

Physician
Department of Neurology, National Cerebral and Cardiovascular Center
Suita, Osaka, Japan
HH

Hiroyuki Hashimoto

Manager
Department of Neurology, Osaka Rosai Hospital
Sakai, Osaka, Japan
NO

Nobuyuki Ohara

Dupty　manager
Department of Neurology, Kobe City Medical Center General Hospital
Kobe, Hyogo, Japan
DT

Daisuke Takahashi

Manager
Department of Neurology, National Hospital Organization Osaka Minami Medical Center
Kawachinagano, Osaka, Japan
YA

Yuko Abe

Manager
Department of Neurology, Yodogawa Christian Hospital
Osaka, Osaka, Japan
TT

Tsutomu Takahashi

Manager
Department of Neurology, Hoshigaoka Medical Center
Hirakata, Osaka, Japan
SO

Shuhei Okazaki

Assistant professor
Department of Neurology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan
KT

Kenichi Todo

Assistant professor
Department of Neurology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan
HM

Hideki Mochizuki

Professor
Department of Neurology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan
TS

Tsutomu Sasaki

Professor
Department of Neurology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan

Background: Acute ischemic stroke patients with active cancer have more severe neurological symptoms, elevated risks of stroke recurrence and mortality compared with general population.

Aims: To examine whether von Willebrand factor (vWF) antigen levels at stroke onset were associated with the poor outcomes of stroke patients with cancer.

Methods: Using data from 90 acute ischemic stroke patients with active cancer who were registered in SCAN study (Ischemic Stroke in Patients with Cancer and Neoplasia study; a prospective multicenter, observational study in Japan), we divided patients into two groups according to their median vWF antigen levels (high n=46 or low n=44). SCAN study complied with the Declaration of Helsinki for investigations involving humans, and was approved by the Institutional Review Board of Osaka University Hospital. Written informed consent was obtained from all study patients.

Results: The high vWF group had a significantly higher initial National Institutes of Health Stroke Scale score (median [interquartile range] 7 [3–11.25] vs. 3 [1–8.5]; p < 0.05) and a significantly higher incidence of cryptogenic stroke (32 [70%] vs. 16 [36%]; p < 0.01) and venous thromboembolism (7 [15%] vs. 0 [0%]; p < 0.01), as well as, multiple lesions (28 [62%] vs. 12 [27%]; p < 0.001), than the low vWF group. We observed no significant difference in the rate of stroke recurrence within 1 year between the groups. However, increased vWF levels were an independent predictor of death within 1 year of stroke onset, after adjusting for potential confounders (odds ratio, 6.77; 95% CI, 1.49–30.78; p < 0.05).

Conclusion(s): Elevated vWF antigen levels were associated with adverse outcomes in patients with cancer-associated stroke and may represent a useful biomarker to guide future therapeutic interventions.