Work

Cancer-associated stroke: a comparative analysis of thrombus composition, resistance to lysis, and plasma biomarkers

Year: 2026

Type: article

Abstract: Background: Acute ischemic stroke (AIS) is a significant complication of cancer and may reveal occult malignancy. Whether cancer-related AIS (CAS) provides specific biological features remains unclear. Objectives: This case-control study aimed to characterize thrombi and plasmas from patients with CAS. Methods: thrombolysis using recombinant tissue-type plasminogen activator and were analyzed for composition. Plasma biomarkers were also assessed. Results: = 6), characterized by low red blood cell and high von Willebrand factor content, was identified in CAS, encompassing all 3 NBTE cases. Plasma D-dimer, fibrin monomers, extracellular vesicle-associated tissue factor and myeloperoxidase were significantly higher in patients with CAS than in the combined LAA and CE control groups (31,290 vs 1900 µg/L; 143 vs 9 μg/mL; 143 vs 9 fM; and 51 vs 25 ng/mL, respectively). Conclusions: CAS thrombi exhibit distinct properties, with white thrombi as a hallmark of undiagnosed NBTE. Furthermore, plasma biomarkers such as D-dimer, fibrin monomers, extracellular vesicle-associated tissue factor and myeloperoxidase could help in cancer screening in AIS of unknown etiology.

Source: Research and Practice in Thrombosis and Haemostasis

DOI: 10.1016/j.rpth.2026.106787