dc.contributor.author
Kufner, Anna
dc.contributor.author
Ebinger, Martin
dc.contributor.author
Luijckx, Gert Jan
dc.contributor.author
Endres, Matthias
dc.contributor.author
Siegerink, Bob
dc.date.accessioned
2021-02-03T14:55:46Z
dc.date.available
2021-02-03T14:55:46Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/29477
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-29221
dc.description.abstract
Background:The smoking-thrombolysis paradox refers to a better outcome in smokers who suffer from acute ischemic stroke (AIS) following treatment with thrombolysis. However, studies on this subject have yielded contradictory results and an interaction analysis of exposure to smoking and thrombolysis in a large, multicenter database is lacking. Methods:Consecutive AIS patients admitted within 12 h of symptom onset between 2009 and 2014 from the prospective, multicenter stroke registry (Dutch String-of-Pearls Stroke Study) were included for this analysis. We performed a generalized linear model for functional outcome 3 months post-stroke depending on risk of the exposure variables (smoking yes/no, thrombolysis yes/no). The following confounders were adjusted for: age, smoking, hypertension, atrial fibrillation, diabetes mellitus, stroke severity, and stroke etiology. Results:Out of 468 patients, 30.6% (N= 143) were smokers and median baseline NIHSS was 3 (interquartile range 1-6). Smoking alone had a crude and adjusted relative risk (RR) of 0.99 (95% CI 0.89-1.10) and 0.96 (95% CI 0.86-1.01) for good outcome (modified Rankin Score <= 2), respectively. A combination of exposure variables (smoking and thrombolysis) did not change the results significantly [crude RR 0.87 (95% CI 0.74-1.03], adjusted RR 1.1 (95%CI 0.90-1.30)]. Smoking alone had an adjusted RR of 1.2 (95% CI 0.6-2.7) for recanalization following thrombolysis (N= 88). Conclusions:In patients with mild to moderate AIS admitted within 12 h of symptom onset, smoking did not modify treatment effect of thrombolysis.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
thrombolysis (tPA)
en
dc.subject
ischemic stroke
en
dc.subject
cerebrovascular risk factors
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Smoking Does Not Alter Treatment Effect of Intravenous Thrombolysis in Mild to Moderate Acute Ischemic Stroke—A Dutch String-of-Pearls Institute (PSI) Stroke Study
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
786
dcterms.bibliographicCitation.doi
10.3389/fneur.2020.00786
dcterms.bibliographicCitation.journaltitle
Frontiers in Neurology
dcterms.bibliographicCitation.originalpublishername
Frontiers Media SA
dcterms.bibliographicCitation.volume
11
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32849233
dcterms.isPartOf.eissn
1664-2295