Effects of smoking on the prognosis of anterior circulation acute ischemic stroke with intravenous thrombolysis

Clin Neurol Neurosurg. 2022 Sep:220:107365. doi: 10.1016/j.clineuro.2022.107365. Epub 2022 Jul 14.

Abstract

Objective: This is a single-center retrospective analysis of the clinical data of 516 patients with acute ischemic stroke who underwent intravenous thrombolysis. This study was conducted to compare the therapeutic efficacy of smokers and non-smokers.

Methods: Univariate analysis was used to analyze and compare the clinical data of smokers and non-smokers. Multivariate analysis was used to assess risk factors affecting the 90-day modified Rankin Scale (mRS) score.

Results: Among the 516 patients, 235 (45.5 %) were smokers. Univariate analysis showed that smokers have a better 90-day prognosis and a lower 90-day mRS score than non-smokers. Multivariate logistic regression analysis showed that smoking is not a protective factor affecting prognosis, while baseline National Institutes of Health Stroke Scale (NIHSS) score was an independent risk factor affecting the 90-day functional outcome. Subgroup analysis did not determine a relationship between the 90-day mRS score and the smoking intensity and duration.

Conclusion: Smoking was not associated with a good 90-day prognosis after intravenous thrombolysis (IVT) treatment. The good clinical outcome of smokers in univariate analysis was bound up with their baseline characteristics. Baseline NIHSS score was the independent risk factor that affected the 90-day outcome of AIS patients undergoing IVT.

Keywords: Acute ischemic stroke; Intravenous thrombolysis; Prognosis; Smoking.

MeSH terms

  • Brain Ischemia* / complications
  • Brain Ischemia* / drug therapy
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Ischemic Stroke* / drug therapy
  • Prognosis
  • Retrospective Studies
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Stroke* / complications
  • Stroke* / drug therapy
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator