Title : Long-Term prognosis after TIA/stroke in patients with or without cancer and evaluation of fasting total- cholesterol and triglyceride levels on different outcomes
This study is about reporting annual events of strokes, myocardial infarctions and deaths, in patients who had been hospitalized due to TIA/stroke in 1986 and followed up until February 2011; with or without cancer, and in patients with assessed lipid values after admission also report predictors of stroke, myocardial infarction (MI) and death. A total of 288 men were followed up for 2254 years (mean 7.8 years) and 261 women for 1984 years (mean 7.6 years). Among these patients 67 men had a total of 78 malignant cancers during life with a follow- up period of 577 years (mean 8.6 years) after admission compared to 69 women had 72 malignant cancers with a follow- up period of 588 years (mean 8.5 years). Fasting total-cholesterol (TC)/ triglyceride (TG) value was measured after admission in 124 men and 96 women.
New stroke was a statistically, significantly more common cause of death in the group of male patients who did not have a malignant cancer (p=.004), as was fatal MI in women (p=.016). The type of cancer, past cancer or not, and patient sex was each an important factor regarding the annual risk of stroke or MI. Patients with a diagnosis of malignant cancer first after TIA/stroke usually appear to have lower annual risk of stroke/MI compared to patients without cancer diagnosis.
Among men with assessed lipid value there was almost a linear correlation between increasing TC levels (< 5 mmol/L; 5-6.4 mmol/L; and ≥ 6.5 mmol/L), and increasing risk of MI during life, P= .016, and cardiovascular death (CVD) (not index stroke), P = .002 compared to women who had a U-shaped correlation. Men had an inverse correlation between TC levels and death due to cancer, P=.008. According to Cox regression analyses, predictors of ischemic stroke were age, sex, diagnosis, history of diabetes/fasting blood glucose ≥ 6.1 mmol/L, angina pectoris; predictors of myocardial infarction were systolic blood pressure, angina pectoris, TC ≥ 6.5 mmol/L and predictors of death were age, sex, history of diabetes/fasting blood glucose ≥ 6.1 mmol/L, TIA/severity, hypertension/treatment with antihypertensive drugs, previous MI, TG > 2.2 mmol/L, and first-line treatment.
What will the audience learn from your presentation?
Cancer itself and/or its treatment may have impact on the annual risk of (fatal) stroke/MI compared to non-cancer patients in patients with TIA/stroke
TC and TG levels measured after admission effect men and women differently regarding the risk for stroke, MI, cardiovascular death and survival. These differences in outcomes between the sexes might support that the indication for lipid-lowering treatment is partly dependent on sex.