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キタガワ カズオ
KITAGAWA Kazuo
北川 一夫 所属 医学部 医学科（東京女子医科大学病院） 職種 非常勤嘱託 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Association of Transcranial Doppler Microembolic Signal With Short-Term Mortality in Acute Ischemic Stroke and Active Cancer. |
| 掲載誌名 | 正式名：Journal of the American Heart Association 略 称：J Am Heart Assoc ISSNコード：20479980/20479980 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 13(15),pp.e033634 |
| 著者・共著者 | Toi Sono, Higuchi Eiko, Hosoya Megumi, Arai Satoko, Ishizuka Kentaro, Mizuno Takafumi, Hoshino Takao, Tsutsumi Yukiko, Kitagawa Kazuo |
| 発行年月 | 2024/08 |
| 概要 | BACKGROUND:This study aimed to clarify the characteristics and survival prediction value of transcranial Doppler microembolic signals (MES) in patients with acute cerebral infarction and active cancer.METHODS AND RESULTS:Between 2017 and 2022, 1089 cases of acute cerebral infarction were recorded within 7 days of disease onset. Among them, transcranial Doppler was successful in 33 patients who had active cancer, and these data were analyzed in this study. The primary outcomes were stroke recurrence and mortality at 3 months. The study population had the following characteristics [median (interquartile range)]: age, 70 years (63-78); body mass index, 21.6 (20-24), National Institutes of Health Stroke Scale 3 (1-6), and modified Rankin Scale score at discharge 1 (1-4). The most common cancer types were lung (24%), pancreatic (24%), and intestinal (18%). MES was present in 16 of 33 patients (48.5%). The presence and number of MES were significantly associated with the levels of D-dimer (P <0.001) and C-reactive protein (P=0.012). Moreover, the presence of MES was associated with multiple ischemic lesions and the 3-territory sign on magnetic resonance imaging. Of the 33 patients, 9 died at 3 months, and 1 had stroke recurrence. On Cox multivariate analysis, using the MES-negative group as a reference, the presence of MES was significantly associated with all-cause death (adjusted hazard ratio, 12.19 [95% CI, 1.45-216.85]; P=0.020).CONCLUSIONS:In patients with acute ischemic stroke and active cancer, the presence of MES was associated with D-dimer and C-reactive protein levels and multiple and 3-territory ischemic lesions, and was predictive of short-term survival. |
| DOI | 10.1161/JAHA.123.033634 |
| PMID | 39082410 |