Tzu Chi Medical Journal

REVIEW ARTICLE
Year
: 2019  |  Volume : 31  |  Issue : 3  |  Page : 144--148

Anticoagulants for cancer-associated ischemic stroke


Jin-Yi Hsu1, An-Bang Liu2 
1 Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
2 Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Medicine, Tzu Chi University, Hualien, Taiwan

Correspondence Address:
Dr. An-Bang Liu
Department of Neurology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, 707, Section 3, Chung-Yang Road, Hualien
Taiwan

Patients with cancer-associated ischemic stroke pose similar clinical manifestations and image characteristics, mainly embolic infarction, as patients with atrial fibrillation do. D-dimer, a degraded product of fibrin polymer, is a useful indicator of hypercoagulability, which frequently increases in cancer-associated stroke, but not in stroke resulted from atrial fibrillation. The level of serum D-dimer is associated with mortality, prognosis, and recurrence of systemic thromboembolism in these patients. Theoretically, drugs block coagulation cascade, such as heparin and low-molecular-weight-heparin (LMWH), oral direct anticoagulants, could attenuate the status of hypercoagulation and decrease the amount of D-dimer. These drugs may be helpful to prevent thromboembolic events in patients with cancer-associated hypercoagulability. Vitamin K antagonist, warfarin, decreases the production of coagulation factors, but not interrupts coagulation cascade may not be helpful to decrease hypercoagulability, but increase the risk of bleeding. However, the treatment of cancer-associated embolic stroke is still controversial. This article reviews relevant clinical studies and proposes the applicability of direct oral anticoagulants from the pathophysiological mechanism.


How to cite this article:
Hsu JY, Liu AB. Anticoagulants for cancer-associated ischemic stroke.Tzu Chi Med J 2019;31:144-148


How to cite this URL:
Hsu JY, Liu AB. Anticoagulants for cancer-associated ischemic stroke. Tzu Chi Med J [serial online] 2019 [cited 2019 Jun 24 ];31:144-148
Available from: http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=3;spage=144;epage=148;aulast=Hsu;type=0