INVISIBLE-1 aims to prospectively follow patients up to one year after ischemic stroke to:
1. Determine the cumulative incidence of occult cancer in patients with embolic stroke of undetermined source (ESUS) and elevated D-dimer 2. Describe occult cancer characteristics and spontaneous course of occult cancer
Methodology
The investigators will include 370 stroke patients with elevated D-dimer (≥ 820 μg/L) at the time of stroke, suspicion of ESUS after initial workup and without known cancer. The investigators will perform a follow-up telephone interview at one year to assess the occurrence of a new cancer and characterize the course of the disease.
Significance
Determining the real incidence of occult cancer in high-risk patients will help support the implementation of screening trials in the future. Faster detection and treatment of occult cancers would significantly impact patient' outcomes by offering faster cancer treatment and optimal secondary stroke prevention.
Informed consent as documented by signature from patient or next of kin
Age ≥ 18 years old
Acute ischemic stroke with symptom onset within 48 h before admission
persistent signs and symptoms of stroke lasting for ≥ 24 hours OR
Active cancer** known at time of index-stroke
Intravenous Thrombolysis administrated prior to D-dimer measurement: Use of external laboratory value possible if available
New diagnosis of central nervous system cancer
Patient or next of kin (in case of lacking capacity) unlikely to be compliant or available for study follow-up interview