Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Smoking–Thrombolysis Relationship Depends on Ischemic Stroke Subtype
First author：Xu Tong
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Xu Tong
- Data Sources： TIMS-CHINA
- Number of papers：TIMS-CHINA20190121
- Published time：2016-04-06
2016-04-06
Published articles
Journal：Stroke
Publication type: Original Contributions
IF(IF): 7.914
PMID: 27222526 Link To Pubmed Full text Download
Background And Purpose
The relationship between smoking and the outcome in patients received thrombolysis is undetermined. The outcome could be influenced by different stroke subtypes. This study aimed to explore whether smoking had any impact on the outcome in stroke patients of different subtypes who received intravenous thrombolysis (IVT).
Method
All patients who received IVT within 4.5 hours after symptom onset from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) database were eligible to be entered into this analysis. Smokers were considered if they smoked at least 1 cigarette per day for more than 6 months prior to stroke. Ischemic stroke subtype was classified by using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Outcome measurements included post-IVT symptomatic intracranial hemorrhage within 7 days, mortality and functional independence at 90 days. The relationship between smoking and thrombolysis was analyzed by using univariate and multivariate logistic regression models.
Conclusion
In patients treated with IVT, smoking could be related to a better chance of functional independence if their subtype of stroke was non-cardioembolic, and a lower risk of symptomatic intracranial hemorrhage and mortality in those with large artery atherosclerosis.
Main results
Of 1118 patients enrolled, we identified 454 smokers and 664 nonsmokers. After stratifying for ischemic stroke subtypes, multivariate analysis revealed a significant relationship between smoking and functional independence in patients with non-cardioembolism stroke subtypes (large artery atherosclerosis: odds ratio [OR]=1.452, 95% confidence interval [CI]=1.053-2.264; small artery occlusion: OR=4.275, 95% CI=1.098-16.649; Other: OR=3.120, 95% CI=1.162-8.373). Furthermore, smoking was specially related to lower rates of symptomatic intracranial hemorrhage (OR=0.316, 95% CI=0.120-0.832) and mortality (OR=0.272, 95% CI=0.128-0.577) in patients with large artery atherosclerosis subtype.