国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

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Smoking–Thrombolysis Relationship Depends on Ischemic Stroke Subtype

第一作者：Xu Tong

通讯作者：Yongjun Wang,Yilong Wang

atherosclerosis intracranial hemorrhages smoking

基本信息

  • 负责人：Xu Tong
  • 数据来源： TIMS-CHINA
  • 论文编号：TIMS-CHINA20190121
  • 发表时间：2016-04-06

2016-04-06

已发表文章

发表杂志：Stroke

发表类型: Original Contributions

影响因子(IF): 7.914

PMID: 27222526 Pubmed原文链接 全文下载

主要研究背景及目的

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).

方法

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.

结论

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.

主要结果

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.