Literature DB >> 24527872

Is smoking associated with favourable outcome in tPA-treated stroke patients?

C E Kvistad1, H Oeygarden, N Logallo, L Thomassen, U Waje-Andreassen, H Naess.   

Abstract

BACKGROUND: Smoking has been associated with improved outcome in thrombolysed patients with myocardial infarction and higher recanalization rates in stroke patients treated with tissue plasminogen activator (tPA). We hypothesized a positive association between smoking and favourable outcome in stroke patients treated with tPA and no such association in acute stroke patients not treated with tPA, suggesting a beneficial effect of smoking on thrombolysis with tPA.
METHODS: Stroke patients treated with tPA and stroke patients not treated with tPA, but presenting within 6 h after stroke onset, were included in two separate groups. Three groups were defined according to smoking habits: current smoking, previous smoking and no smoking. Functional outcome by modified Rankin Scale (mRS) was assessed after 1 week or at discharge, if discharged earlier. Favourable outcome was defined as mRS 0 or 1.
RESULTS: A total of 399 patients were treated with tPA (94 current smokers, 148 previous smokers and 157 non-smokers), whereas 424 patients were not treated with tPA (90 current smokers, 164 previous smokers and 170 non-smokers). Current smoking was independently associated with favourable outcome in patients treated with tPA when adjusted for confounders (OR 2.08, 95% CI 1.09-3.95, P = 0.025). There was no such association in acute stroke patients not treated with tPA (OR 1.26, 95% CI 0.67-2.36, P = 0.472).
CONCLUSION: Our study showed an association between current smoking and favourable short-term outcome in stroke patients treated with tPA, but not in acute stroke patients not treated with tPA. This may indicate a more effective thrombolysis with tPA in smokers.
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  acute ischaemic stroke; smoking; tPA; thrombolysis

Mesh:

Substances:

Year:  2014        PMID: 24527872     DOI: 10.1111/ane.12225

Source DB:  PubMed          Journal:  Acta Neurol Scand        ISSN: 0001-6314            Impact factor:   3.209


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