The effect of metabolic syndrome and obesity on outcomes of acute ischemic stroke patients treated with systemic thrombolysis

摘要

Abstract Metabolic syndrome (MetS) is associated with increased risk of ischemic stroke; while central obesity has controversial effects on ischemic stroke. We investigated effects of MetS and obesity on clinical courses and outcomes of patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA). 319 patients treated with intravenous thrombolysis were included to our study. Metabolic syndrome was determined if ≥3 of following criteria are present: elevated waist circumference; elevated triglycerides; reduced high density-lipoprotein cholesterol (HDL-C); elevated blood pressure; elevated fasting glucose. Obesity was defined as BMI≥30. Clinical features at baseline, 24th hour and 3rd month were examined. Computed tomography (CT) findings for ASPECT scores and hemorrhagic transformation were analyzed. 182 patients were MetS+; they were older ( p = 0.035 ), had similar ASPECT scores ( p = 0.477 ) and NIHSS scores ( p = 0.167 ) at admission; had significantly higher NIHSS scores at 24th hour ( p 0.001 ) and worse outcome at 3rd month ( p 0.001 ). Logistic regression analysis showed that either MetS, obesity or age were not independent predictors of poor outcome. Obese patients (n:72) had slight but significantly lower NIHSS scores at admission ( p = 0.049 ) compared to non-obese patients; meanwhile there was no significant difference between NIHSS scores at 24th hour ( p = 0.736 ) and 3rd month mRS scores ( p = 0.145 ). Hemorrhagic transformation and mortality rates were not affected with MetS or obesity. MetS is not an independent factor on clinical outcome but its presence may have a relationship with poor outcome; but obesity was not found to have any significant role on clinical course and outcome of patients treated with iv rt-PA. Highlights ? In acute ischemic stroke patients treated with iv rt-PA MetS may be associated with poor outcome, but not an independent factor.