Serum Ferritin and D-Dimer as Possible Risk Factors in Ischaemic Stroke in Cancer Patients

Abstract

Background: Ischemic stroke is frequently encountered in patients with malignant disease. The pathophysiology of stroke in such cases differs from other subjects with no malignant disease. This study was conducted to compare serum levels of ferritin and d-dimer in cases with ischemic stroke in cancer versus non-cancer patients. Patients and methods: The data of consecutive 264 patients presented with ischemic stroke, confirmed by clinical examina-tion and radiological investigations, were retrospectively reviewed. The included cases were divided into two groups: Group A (non-cancer with stroke, 210 cases) and Group B (cancer with stroke, 54 cases). The collected data included patient demographics, systemic comorbidities, disease and tumor characteristics, in addition to platelet count, serum ferritin and d-dimer. Results: Age, gender, and systemic comorbidities were statistically comparable between the two groups. Additionally, the etiology of stroke and its disability were not statistically different between the two groups. However, the incidence of mortality significantly increased in Group B (25.93% vs. 7.14% of Group A, p = 0.005). Both serum ferritin and d-dimer showed a significant increase in association with cancer (Group B). The former had mean values of 294.54 and 867.87 ng/ml, while the latter had mean values of 463.83 and 888.13 ng/ml in the same two groups, respectively. Conclusion: Serum ferritin and d-dimer showed a significant rise in cancer-associated ischemic stroke. This confirms the role of the hypercoagulable state, associated with malignancy in the development of this morbidity.