Tissue factor activity and 1-year mortality in patients with active cancer and acute ischemic stroke: findings from the SCAN study

Background: Tissue factor (TF), the cellular receptor for plasma factor (F)VII/FVIIa and a key initiator of the extrinsic coagulation pathway, plays a central role in cancer-associated thrombosis. However, its prognostic significance in patients with active cancer (AC) and acute ischemic stroke (AIS) remains unclear. Objectives: This study evaluates the association between plasma TF activity and outcome in patients with AC and AIS. Methods: We analyzed data from the SCAN study, a prospective, multicenter, observational study conducted in Japan. Blood samples were obtained immediately after admission, prior to any stroke treatment. TF activity was measured using a chromogenic assay. Patients were dichotomized at the median TF activity. Kaplan-Meier survival and Cox proportional hazards models were used to assess 1-year mortality, and restricted cubic spline analysis was conducted to explore nonlinear associations between TF activity and mortality. Conclusion: Elevated TF activity was independently associated with 1-year mortality in patients with AC and AIS. TF activity represents a potential prognostic biomarker in this population.