22. European Stroke Conference 292 Etiology of stroke and risk factors DIAGNOSIS OF NEOPLASIAS IN STROKE PATIENTS: UTILITY OF TUMOR MARK-ERS. 440 © 2013 S. Karger AG, Basel Scientific Programme M. A. Mangas-Guijarro1, O. Trabajos2, P. Martinez-Sanchez3, A. Tallón4, M.J. Aguilar-Amat5, E. Blanco-Vicente6, A. Martin-Montes7, B. Fuentes8, E. Díez-Tejedor9 Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN1, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN2, Department of Neurology and Stroke Centre. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN3, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN4, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN5, Department of Neurology and Stroke Centre. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN6, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN7, Department of Neurology and Stroke Centre. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN8, Department of Neurology and Stroke Centre. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN9 BACKGROUND: our objective was to analyze the frequency of tumors diagnosis after a brain in-farction a well as the prognostic value of tumor markers (TM). METHODS: Observational study of stroke patients treated in a stroke unit durging 2010. A fol-low- up was performed during 2011. Variables analyzed: demographic data, vascular risk factors, stroke data, MT during admission (CEA, CA125, CA19-9, CA15- 3, AFP and PSA) and diagnosis of any tumor during follow-up. RESULTS: 398 patients, 60% males. A total of 17.3% had prior tumors: active solid tumor (6.5%), active leukemia (0.3%), active lymphoma (0.5%) and solid tumors in complete remission (13.1). Overall, 13 (3.3%) patients were diagnosed with a new neoplasia: 1 prostate cancer, 1 colon ade-nocarcinoma, 3 pulmonary carcinomas, 4 brain tumors, 1 cervix neoplasia and 4 skin tumors. The time to diagnosis was 4.57 (+/- 6.9) months. Three had metastases. TM were analyzed in 89.9% of patients with no history of neoplasia: they were increased in 60% of patients with a new diagnosed neoplasia compared with 9.6% of those without neoplasia (P <0.0001): sensitivity 70% , specificity 84.7%, positive predictive value (PPV) 14%, negative predictive value (NPV) 98.8%. Furthermore, MT were increased in 80% of newly diagnosed tumors with specific MT: sensitivity 80%, specificity 89.9%, PPV 12.1%, NPV 99.6%. CONCLUSIONS: The presence of tumors, previous or new, is common in patients with cerebral in-farction, suggesting a role in ist pathophysiology. The yield of TM in the diagnosis of neoplasias is high although their PPV is low. 293 Etiology of stroke and risk factors The Impact of Baroreceptor Sensitivity in Arterial Hypertension, Ischemic Cerebral Stroke and Coronary Artery Disease. The Role of Carotid Atherosclerosis and Age D. Bartko1, Z. Gombosova2, P. Blazicek3, L. Danihel4, F. Jagla5, M. Hilz6, M. Drobny7, E. Kurca8, V. Nosal9, I. Filipp10 Institue of Medical Sciences, Neurosci & Military Health, Central Military University Hos-pital,, Ruzomberok, SLOVAKIA1, Institute of Medical Sciences, Neurosciences, Military Health,Central Military University Hospital, Ruzomberok, SLOVAKIA2, Alpha Medical Comop., Bratislava, SLOVAKIA3, Institute of Medical Sciences, Neurosciences & Military Health, Dept. of Radiology, Ruzomberok, SLOVAKIA4, Institute of Normak and Pathological Physiology, Sovak Academy of Sciencies, Bratislava, SLOVAKIA5, Dept. of Neurology, University of Erlangen, Er-langen, GERMANY6, Dept. of Neurology, University Hospital, Martin, SLOVAKIA7, Dept. of Neu-rology, University Hosoital, Martin, SLOVAKIA8, Dept. of Neurology, University Hospital, Martin, SLOVAKIA9, Institue of Medical Sciences, Neurosciences and Military Health, Ruzomberok, SLOVAKIA10 Backround The role of baroreceptor sensitivity in arterial hypertension(AH), ischemic cerebral stroke (iCI), coronary artery disease(CAD), and their relationship to carotid atherosclerosis(CA) and age is poorly documented and controversial. We assessed the hypothesis that the changes in baroreceptor sensitivity may correlate with CA (stiff-ness, IMT,plaque morphology) and also with age. This can influence compensatory mechanisms in different clinical situations. Methods Material consists of 1120 subjects, divided in four groups:1. iCI(n=342),mean age 65.4 +/- 9.6,men 50.6%), BMI=29.7 +/-3.8, 2.AH,(n=306),mean age 59,2+/-9.36,men 47.8%,BMI=28.9+/- 5.1, 3.CAD,(n=227),mean age 69,2+/-10.4,men 37.5%),BMI=29.6 +/-3.8, 4.healthy con-trols( C,n=245),mean age 50.9 +/ 11.3,men47,1%,BMI=23.8+/-4.2, Every group was divided in three age-related subgroups:1st group <40yrs,2nd group:41-60yrs,3rd group >60yrs. Diagnoses clearly documented. BRS measured by Finometer(Finapres Amsterdam),stiffness (SphygmoCor,AtCor,Syd-ney) IMT,plaque morphology( carotid USG) Results BRS is significantly lower in all three groups with lowest values in iCI,comparing to con-trols( 92+/-1.76 vs 4.41+/-1.70,p<001). Stiffness(PWV 11.06+/-4.12 vs 8.48+/-1.96), IMT(0.798+/- 0.195 vs 0.648+/-0.123mm) and plaque morphology showed significant higher values in all groups of pts comparing to controls(p<.0001). The changes are in inverse relationship to all parameters of CA (p<.001)..BRS changes are age- related(from 40yrs to more than 60 yrs p< .0001) Conclusion BRS changes have shown lower values and an inverse relationship to all parameters of CA in all groups of pts comparing to controls. They are age-related. The results provoke opinion about pos-sible unfavorable influence of these changes on compensatory mechanisms related to the onset and outcome of cerebrovascular and cardiovascular events. One of the largest prosoective multicenter, multidisciplinary study Supp.by EU/gov.grants ITMS26220220099,APVV 0586-06
Karger_ESC London_2013
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