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May 21, 2014

Recurrent thromboembolic events after ischemic stroke in patients with cancer

Babak B. Navi, MD, Samuel Singer, MD, Alexander E. Merkler, MD, Natalie T. Cheng, MD, Jacqueline B. Stone, MD, Hooman Kamel, MD, Costantino Iadecola, MD, Mitchell S.V. Elkind, MD, MS, and Lisa M. DeAngelis, MDAuthors Info & Affiliations
July 1, 2014 issue
83 (1) 26-33
https://doi.org/10.1212/WNL.0000000000000539
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Abstract

Objective:

To determine the cumulative rate and characteristics of recurrent thromboembolic events after acute ischemic stroke in patients with cancer.

Methods:

We retrospectively identified consecutive adult patients with active systemic cancer diagnosed with acute ischemic stroke at a tertiary-care cancer center from 2005 through 2009. Two neurologists independently reviewed all electronic records to ascertain the composite outcome of recurrent ischemic stroke, myocardial infarction, systemic embolism, TIA, or venous thromboembolism. Kaplan-Meier statistics were used to determine cumulative outcome rates. In exploratory analyses, Cox proportional hazard analysis was used to evaluate potential independent associations between a priori selected clinical factors and recurrent thromboembolic events.

Results:

Among 263 study patients, complete follow-up until death was available in 230 (87%). Most patients had an adenocarcinoma as their underlying cancer (60%) and had systemic metastases (69%). Despite a median survival of 84 days (interquartile range 24–419 days), 90 patients (34%; 95% confidence interval 28%–40%) had 117 recurrent thromboembolic events, consisting of 57 cases of venous thromboembolism, 36 recurrent ischemic strokes, 13 myocardial infarctions, 10 cases of systemic embolism, and one TIA. Kaplan-Meier rates of recurrent thromboembolism were 21%, 31%, and 37% at 1, 3, and 6 months, respectively; cumulative rates of recurrent ischemic stroke were 7%, 13%, and 16%. Adenocarcinoma histology (hazard ratio 1.65, 95% confidence interval 1.02–2.68) was independently associated with recurrent thromboembolism.

Conclusions:

Patients with acute ischemic stroke in the setting of active cancer (especially adenocarcinoma) face a substantial short-term risk of recurrent ischemic stroke and other types of thromboembolism.

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Supplementary Material

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REFERENCES

1.
Bick RL. Cancer-associated thrombosis. N Engl J Med 2003;349:109–111.
Crossref
PubMed
Google Scholar
2.
Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism. Lancet Oncol 2005;6:401–410.
Crossref
PubMed
Google Scholar
3.
Sack GH, Levin J, Bell WR. Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine 1977;56:1–37.
Crossref
PubMed
Google Scholar
4.
Dammacco F, Vacca A, Procaccio P, Ria R, Marech I, Racanelli V. Cancer-related coagulopathy (Trousseau's syndrome): review of the literature and experience of a single center of internal medicine. Clin Exp Med 2013;13:85–97.
Crossref
PubMed
Google Scholar
5.
Graus F, Rogers LR, Posner JB. Cerebrovascular complications in patients with cancer. Medicine 1985;64:16–35.
Crossref
PubMed
Google Scholar
6.
Taccone FS, Jeangette SM, Blecic SA. First-ever stroke as initial presentation of systemic cancer. J Stroke Cerebrovasc Dis 2008;17:169–174.
Crossref
PubMed
Google Scholar
7.
Cestari DM, Weine DM, Panageas KS, Segal AZ, DeAngelis LM. Stroke in patients with cancer: incidence and etiology. Neurology 2004;62:2025–2030.
Crossref
PubMed
Google Scholar
8.
Rogers LR. Cerebrovascular complications in patients with cancer. Semin Neurol 2010;30:311–319.
Crossref
PubMed
Google Scholar
9.
Zhang YY, Chan DK, Cordato D, Shen Q, Sheng AZ. Stroke risk factor, pattern and outcome in patients with cancer. Acta Neurol Scand 2006;114:378–383.
Crossref
PubMed
Google Scholar
10.
Kim SG, Hong JM, Kim HY, et al. Ischemic stroke in cancer patients with and without conventional mechanisms: a multicenter study in Korea. Stroke 2010;41:798–801.
Crossref
PubMed
Google Scholar
11.
Schwarzbach CJ, Schaefer A, Ebert A, et al. Stroke and cancer: the importance of cancer-associated hypercoagulation as a possible stroke etiology. Stroke 2012;43:3029–3034.
Crossref
PubMed
Google Scholar
12.
Seok JM, Kim SG, Kim JW, et al. Coagulopathy and embolic signal in cancer patients with ischemic stroke. Ann Neurol 2010;68:213–219.
Crossref
PubMed
Google Scholar
13.
Chaturvedi S, Ansell J, Recht L. Should cerebral ischemic events in cancer patients be considered a manifestation of hypercoagulability? Stroke 1994;25:1215–1218.
Crossref
PubMed
Google Scholar
14.
Lee AY, Levine MN, Baker RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003;349:146–153.
Crossref
PubMed
Google Scholar
15.
van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke 1988;19:604–607.
Crossref
PubMed
Google Scholar
16.
Lowenstein SR. Medical record reviews in emergency medicine: the blessing and the curse. Ann Emerg Med 2005;45:452–455.
Crossref
PubMed
Google Scholar
17.
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007;335:806–808.
Crossref
PubMed
Google Scholar
18.
Adams HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35–41.
Crossref
PubMed
Google Scholar
19.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903–1913.
Crossref
PubMed
Google Scholar
20.
Zoller B, Ji J, Sundquist J, Sundquist K. Risk of haemorrhagic and ischaemic stroke in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer 2012;48:1875–1883.
Crossref
PubMed
Google Scholar
21.
Li SH, Chen WH, Tang Y, et al. Incidence of ischemic stroke post-chemotherapy: a retrospective review of 10,963 patients. Clin Neurol Neurosurg 2006;108:150–156.
Crossref
PubMed
Google Scholar
22.
Chen PC, Muo CH, Lee YT, Yu YH, Sung FC. Lung cancer and incidence of stroke: a population-based cohort study. Stroke 2011;42:3034–3039.
Crossref
PubMed
Google Scholar
23.
Bal S, Menon B, Demchuk A. Relationship of endocarditis, disseminated intravascular coagulation, and embolic signals in cancer with stroke. Ann Neurol 2012;71:146.
Crossref
PubMed
Google Scholar
24.
Kang DW, Chalela JA, Ezzeddine MA, Warach S. Association of ischemic lesion patterns on early diffusion-weighted imaging with TOAST stroke subtypes. Arch Neurol 2003;60:1730–1734.
Crossref
PubMed
Google Scholar
25.
Singhal AB, Topcuoglu MA, Buonanno FS. Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study. Stroke 2002;33:1267–1273.
Crossref
PubMed
Google Scholar
26.
el-Shami K, Griffiths E, Streiff M. Nonbacterial thrombotic endocarditis in cancer patients: pathogenesis, diagnosis, and treatment. Oncologist 2007;12:518–523.
Crossref
PubMed
Google Scholar
27.
Dutta T, Karas MG, Segal AZ, Kizer JR. Yield of transesophageal echocardiography for nonbacterial thrombotic endocarditis and other cardiac sources of embolism in cancer patients with cerebral ischemia. Am J Cardiol 2006;97:894–898.
Crossref
PubMed
Google Scholar
28.
Rogers LR, Cho ES, Kempin S, Posner JB. Cerebral infarction from non-bacterial thrombotic endocarditis: clinical and pathological study including the effects of anticoagulation. Am J Med 1987;83:746–756.
Crossref
PubMed
Google Scholar
29.
Navi BB, Kamel H, Sidney S, Klingman JG, Nguyen-Huynh MN, Johnston SC. Validation of the Stroke Prognostic Instrument-II in a large, modern, community-based cohort of ischemic stroke survivors. Stroke 2011;42:3392–3396.
Crossref
PubMed
Google Scholar
30.
Zhang YY, Cordato D, Shen Q, Sheng AZ, Hung WT, Chan DK. Risk factor, pattern, etiology and outcome in ischemic stroke patients with cancer: a nested case-control study. Cerebrovasc Dis 2007;23:181–187.
Crossref
PubMed
Google Scholar
31.
Oberndorfer S, Nussgruber V, Berger O, Lahrmann H, Grisold W. Stroke in cancer patients: a risk factor analysis. J Neurooncol 2009;94:227.
Crossref
PubMed
Google Scholar

Information & Authors

Information

Published In

Neurology®
Volume 83 • Number 1 • July 1, 2014
Pages: 26-33
PubMed: 24850486

Copyright

© 2014 American Academy of Neurology.

Publication History

Received: July 18, 2013
Accepted: February 6, 2014
Published online: May 21, 2014
Published in issue: July 1, 2014

Permissions

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Disclosure

B. Navi is supported by NIH grant KL2 TR000458-06 administered through the Weill Cornell CTSC. S. Singer, A. Merkler, N. Cheng, J. Stone, H. Kamel, and C. Iadecola report no disclosures relevant to the manuscript. M. Elkind is an editor for Neurology®. L. DeAngelis receives research support through NIH grant KL2 (for mentorship of Babak Navi). Go to Neurology.org for full disclosures.

Study Funding

Supported by an NIH KL2 grant administered to Dr. Navi through the Cornell Clinical and Translational Science Center (CTSC).

Authors

Affiliations & Disclosures

Babak B. Navi, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) National Institute of Health through the Weill Cornell Clinical and Translational Science Center, KL2 TR000458-06, Investigator, 2012-2014
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Samuel Singer, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Alexander E. Merkler, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Natalie T. Cheng, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Jacqueline B. Stone, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Hooman Kamel, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
(1) Scientific advisory board for Genentech, Inc., 2012.
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) Journal Watch Neurology, Associate Editor, 2011-current. (2) PLOS One, Academic Editor, 2013-current.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
(1) Speakers bureau for Genentech, Inc., 2012-current
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) NIH/NINDS, K23082367, 2013-current.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
(1) AHA, 13SDG14560037, 2013.
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Costantino Iadecola, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Hypertension (Guest Editor), Present Stroke (Consulting Editor), Present Annals of Neurology (Editorial Board), Present Journal of Cerebral Blood Flow and Metabolism (Editorial Board), Present Cerebrovascular Diseases (Editorial Board), Present Cellular and Molecular Neurobiology (Editorial Board), Present
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Source: NIH (Program project #1PO1 HL096571); Program Director: C. Iadecola; Period: 7/09-6/14; Source: National Institutes of Health; (1R01NS073666); P.I. C. Iadecola; Period: 4/11-3/16; Source: National Institutes of Health;(R01-NS/HL37853); P.I. C. Iadecola; 6/12-5/17 Source: National Institutes of Health; (R01-NS34179); P.I. C. Iadecola; 12/11-11/16
Research Support, Academic Entities:
1.
Weill Cornell Medical College
Research Support, Foundations and Societies:
1.
Alzheimer's Association Leon Levy Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Mitchell S.V. Elkind, MD, MS
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
(1) Jarvik Heart, Clinical Events Committee member, adjudicating events in clinical trial of artificial heart (2008-2013); (2) Biogen IDEC, scientific advisory board, stroke trial design (2013)
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) Neurology, Resident and Fellow Section editor, published by American Academy of Neurology (2007-present)
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
Columbia University
Consultancies:
1.
(1) BMS-Pfizer Partnership, consultant regarding antithrombotics for stroke; (2) Janssen Pharmaceutical, consultation regarding antithrombotics for stroke; (3) Daiichi Sankyo: consultation regarding antithrombotics for stroke
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) diaDexus, Inc: funding for biomarker research; (2) BMS-Sanofi Pharmaceutical Partnership: funding for biomarker research
Research Support, Government Entities:
1.
(1) NIH/NINDS P50 NS049060, Project PI, 2004�2013; (2) NIH/NINDS R37 NS029993, Co-PI, 2008-2013; (3) NIH/NINDS 1R25 NS070697, PI, 2010�2015; NIH/NHLBI R01 HL111195, Co-PI, 2012-2016; (4) NIH/NINDS R01 NS062820, Co-I, 2009-2014; (5) NIH/NINDS 1U01 NS069763, Co-I, 2010-2015; (6) NIH/NHLBI HL108623, Co-I, 2011-2016
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
(1) American Heart Association Founders Affiliate Board of Directors)(2008-2013); (2) American Heart Association NY City Board of Directors (2011-present)
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
(1) GSK, Avandia and stroke litigation, 2009-2011; (2) Organon/Merck, NuvaRing and stroke litigation, 2009-present; (3) Novartis, aliskiren and stroke litigation, 2013-present
View all articles by this author
Lisa M. DeAngelis, MD
From the Department of Neurology and the Brain and Mind Research Institute (B.B.N., A.E.M., N.T.C., J.B.S., H.K., C.I., L.M.D.), Weill Cornell Medical College, New York; Department of Neurology (B.B.N., S.S., L.M.D.), Memorial Sloan-Kettering Cancer Center, New York; and Department of Neurology (M.S.V.E.), Columbia University, New York, NY.
Disclosure
Scientific Advisory Boards:
1.
National Football League Players Association
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Editorial Board: Neurology, Neuro-Oncology, Journal of Neuro-oncology
Patents:
1.
NONE
Publishing Royalties:
1.
Oxford University Press, 2008 The Neurologic Complications of Cancer, Lisa M. DeAngelis and Jerome B. Posner
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH UO1 CA-105663-01 Participating Member in the NABTC, 2003-2013 CTSC KL2 Scholar Award, KL2TR000458 (Dr. Babak Navi)A Pilot Trial of Enoxaprin vs. Aspirin in Patients with Cancer and Stroke $115,600; Mentor: Lisa M. DeAngelis, MD ($11,520/year)
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author

Notes

Correspondence to Dr. Navi: [email protected]
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

Babak B. Navi conceived and designed the study, analyzed and interpreted the data, and drafted and revised the manuscript for intellectual content. Samuel Singer, Alexander E. Merkler, and Natalie T. Cheng designed the study, analyzed and interpreted the data, and revised the article critically for important intellectual content. Jacqueline B. Stone analyzed and interpreted the data and revised the article critically for important intellectual content. Hooman Kamel and Costantino Iadecola designed the study, analyzed and interpreted the data, and revised the article critically for important intellectual content. Mitchell S.V. Elkind analyzed and interpreted the data and revised the article critically for important intellectual content. Lisa M. DeAngelis designed the study, analyzed and interpreted the data, and revised the article critically for important intellectual content.

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