{"id":344405,"date":"2014-10-15T00:00:00","date_gmt":"2014-10-14T22:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/une-etude-retrospective-donne-peu-despoir-aux-patients-atteints-davc-et-de-cancer\/"},"modified":"2014-10-15T00:00:00","modified_gmt":"2014-10-14T22:00:00","slug":"une-etude-retrospective-donne-peu-despoir-aux-patients-atteints-davc-et-de-cancer","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/fr\/une-etude-retrospective-donne-peu-despoir-aux-patients-atteints-davc-et-de-cancer\/","title":{"rendered":"Une \u00e9tude r\u00e9trospective donne peu d&#8217;espoir aux patients atteints d&#8217;AVC et de cancer"},"content":{"rendered":"<p><strong>L&#8217;objectif d&#8217;une nouvelle \u00e9tude \u00e9tait de d\u00e9terminer la fr\u00e9quence et la nature des \u00e9v\u00e9nements thromboemboliques r\u00e9currents apr\u00e8s un AVC isch\u00e9mique aigu. Il s&#8217;agissait uniquement de patients victimes d&#8217;un accident vasculaire c\u00e9r\u00e9bral qui souffraient \u00e9galement d&#8217;un cancer.<\/strong><\/p>\n<p> <!--more--> <\/p>\n<p>Un \u00e9chantillon r\u00e9trospectif de 263 participants a \u00e9t\u00e9 cr\u00e9\u00e9 (de 2005 \u00e0 2009), compos\u00e9 de patients adultes atteints d&#8217;un cancer syst\u00e9mique et diagnostiqu\u00e9s avec un AVC isch\u00e9mique aigu. L&#8217;issue composite d&#8217;un AVC isch\u00e9mique r\u00e9current, d&#8217;un infarctus du myocarde, d&#8217;une embolie syst\u00e9mique, d&#8217;un accident isch\u00e9mique transitoire (AIT) ou d&#8217;une thromboembolie veineuse a \u00e9t\u00e9 d\u00e9termin\u00e9e ind\u00e9pendamment par deux neurologues \u00e0 partir de tous les dossiers \u00e9lectroniques disponibles sur les patients.<\/p>\n<h2 id=\"les-evenements-thromboemboliques-recurrents-sont-frequents\">Les \u00e9v\u00e9nements thromboemboliques r\u00e9currents sont fr\u00e9quents<\/h2>\n<p>Une documentation compl\u00e8te jusqu&#8217;au d\u00e9c\u00e8s \u00e9tait accessible pour 230 patients (87%). Plus de la moiti\u00e9 des patients (60%) pr\u00e9sentaient un ad\u00e9nocarcinome et un peu plus des deux tiers avaient des m\u00e9tastases syst\u00e9miques. Malgr\u00e9 une survie m\u00e9diane de 84 jours, pas moins de 90 patients, soit 34% de l&#8217;\u00e9chantillon, ont subi un total de 117 \u00e9v\u00e9nements thromboemboliques r\u00e9currents, un taux \u00e9lev\u00e9 compte tenu de la courte dur\u00e9e de survie. Les thromboembolies veineuses ont \u00e9t\u00e9 les plus fr\u00e9quentes (57 cas), suivies par les r\u00e9cidives d&#8217;AVC isch\u00e9mique (36), les infarctus du myocarde (13), les embolies syst\u00e9miques (10) et les AIT (1).<\/p>\n<p>Les taux Kaplan-Meier de thromboembolies r\u00e9currentes \u00e9taient de 21% \u00e0 un mois, de 31% \u00e0 trois mois et de 37% \u00e0 six mois. Pour les AVC isch\u00e9miques r\u00e9currents, les taux cumulatifs \u00e9taient respectivement de 7, 13 et 16%. Ces valeurs d\u00e9passent presque trois fois celles des patients victimes d&#8217;un AVC sans cancer.<\/p>\n<p>De plus, le diagnostic d&#8217;ad\u00e9nocarcinome \u00e9tait ind\u00e9pendamment associ\u00e9 \u00e0 de nouvelles thromboembolies.<\/p>\n<h2 id=\"previsions-negatives\">Pr\u00e9visions n\u00e9gatives<\/h2>\n<p>Les auteurs concluent que les patients atteints d&#8217;ad\u00e9nocarcinome, mais aussi d&#8217;autres cancers, doivent \u00eatre conscients qu&#8217;apr\u00e8s avoir subi un AVC aigu, il existe un risque important \u00e0 court terme d&#8217;autres \u00e9v\u00e9nements thromboemboliques et d&#8217;un nouvel AVC. Et ce, bien que l&#8217;esp\u00e9rance de vie de ces patients soit g\u00e9n\u00e9ralement courte. La question du m\u00e9canisme pathologique exact sous-jacent reste largement ouverte.<\/p>\n<p>Si ces r\u00e9sultats sont confirm\u00e9s dans des \u00e9tudes prospectives, ils pourraient avoir des cons\u00e9quences sur le traitement pr\u00e9ventif des patients atteints de cancer apr\u00e8s un AVC.<\/p>\n<p><em>Source : Navi BB, et al : \u00c9v\u00e9nements thromboemboliques r\u00e9currents apr\u00e8s un accident vasculaire c\u00e9r\u00e9bral isch\u00e9mique chez les patients atteints de cancer. Neurology 2014 Jul 1 ; 83(1) : 26-33.<\/em><\/p>\n<h4 id=\"info-onkologie-hamatologie-2014-28-2\">\n<em>InFo ONKOLOGIE &amp; H\u00c4MATOLOGIE 2014 ; 2(8) : 2<\/em><\/h4>\n","protected":false},"excerpt":{"rendered":"<p>L&#8217;objectif d&#8217;une nouvelle \u00e9tude \u00e9tait de d\u00e9terminer la fr\u00e9quence et la nature des \u00e9v\u00e9nements thromboemboliques r\u00e9currents apr\u00e8s un AVC isch\u00e9mique aigu. Il s&#8217;agissait uniquement de patients victimes d&#8217;un accident vasculaire&hellip;<\/p>\n","protected":false},"author":7,"featured_media":47135,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Cancer et attaque c\u00e9r\u00e9brale","footnotes":""},"category":[11523,11527,11383,11389,11549],"tags":[12894,15772,50312,50320,18559,22648],"powerkit_post_featured":[],"class_list":["post-344405","post","type-post","status-publish","format-standard","has-post-thumbnail","category-actualites","category-etudes","category-neurologie-fr","category-oncologie","category-rx-fr","tag-accident-vasculaire-cerebral-fr","tag-attaque-cerebrale","tag-etude-retrospective","tag-evenements-thromboemboliques","tag-thromboembolie-fr","tag-tia-fr","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-11 12:05:05","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"fr_FR","wpml_translations":{"it_IT":{"locale":"it_IT","id":344418,"slug":"uno-studio-retrospettivo-da-poche-speranze-ai-pazienti-affetti-da-ictus-con-cancro","post_title":"Uno studio retrospettivo d\u00e0 poche speranze ai pazienti affetti da ictus con cancro","href":"https:\/\/medizinonline.com\/it\/uno-studio-retrospettivo-da-poche-speranze-ai-pazienti-affetti-da-ictus-con-cancro\/"},"pt_PT":{"locale":"pt_PT","id":344426,"slug":"estudo-retrospectivo-da-pouca-esperanca-aos-doentes-com-cancro","post_title":"Estudo retrospectivo d\u00e1 pouca esperan\u00e7a aos doentes com cancro","href":"https:\/\/medizinonline.com\/pt-pt\/estudo-retrospectivo-da-pouca-esperanca-aos-doentes-com-cancro\/"},"es_ES":{"locale":"es_ES","id":344432,"slug":"un-estudio-retrospectivo-da-pocas-esperanzas-a-los-pacientes-de-ictus-con-cancer","post_title":"Un estudio retrospectivo da pocas esperanzas a los pacientes de ictus con c\u00e1ncer","href":"https:\/\/medizinonline.com\/es\/un-estudio-retrospectivo-da-pocas-esperanzas-a-los-pacientes-de-ictus-con-cancer\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/344405","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/comments?post=344405"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/344405\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media\/47135"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media?parent=344405"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/category?post=344405"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/tags?post=344405"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/powerkit_post_featured?post=344405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}