5 years ago

Cancer and risk of cerebral venous thrombosis: a case-control study

S. M. Zuurbier, E. Lindgren, S. C. Cannegieter, T. Tatlisumak, S. Middeldorp, S. M. Silvis, K. Jood, J. M. Coutinho, J. Putaala, S. Hiltunen
Background Cancer is an established risk factor for leg vein thrombosis and pulmonary embolism. Controlled studies assessing the risk of cerebral venous thrombosis (CVT) in patients with cancer have not been performed. Objective To assess whether cancer is a risk factor for CVT. Patients/Methods Case-control study. We assessed consecutive adult patients with CVT from three academic hospitals from 1987-2015, and control subjects from the Dutch MEGA study (Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). We adjusted for age, sex and oral contraceptive use, and stratified for type of cancer and time since diagnosis of cancer. Results We included 594 cases and 6278 controls. In total, 53 cases (8.9%) and 160 controls (2.5%) had a history of cancer. Cases were younger (median 42 vs. 48 years), more often female (68% vs. 54%) and more often used oral contraceptives (55% vs. 23%) than controls. The risk of CVT was increased in patients with cancer compared to those without cancer (adjusted odds ratio [aOR] 4.86, 95% confidence interval [CI] 3.46-6.81). Patients with a hematological type of cancer had a higher risk of CVT (aOR 25.14, 95% CI 11.64-54.30) than those with a solid type of cancer (aOR 3.07, 95% CI 2.03-4.65). The association was strongest in the first year after diagnosis of cancer (hematological aOR 85.57, 95% CI 19.70-371.69; solid aOR 10.50, 95% CI 5.40-20.42). Conclusions Our study indicates that cancer is a strong risk factor for CVT, particularly within the first year of diagnosis and in patients with a hematological type of cancer. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/jth.13903

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