Association of prestroke metformin use, stroke severity, and thrombolysis outcome.

Details

Serval ID
serval:BIB_60D5FF42E716
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association of prestroke metformin use, stroke severity, and thrombolysis outcome.
Journal
Neurology
Author(s)
Westphal L.P., Widmer R., Held U., Steigmiller K., Hametner C., Ringleb P., Curtze S., Martinez-Majander N., Tiainen M., Nolte C.H., Scheitz J.F., Erdur H., Polymeris A.A., Traenka C., Eskandari A., Michel P., Heldner M.R., Arnold M., Zini A., Vandelli L., Coutinho J.M., Groot A.E., Padjen V., Jovanovic D.R., Bejot Y., Brenière C., Turc G., Seners P., Pezzini A., Magoni M., Leys D., Gilliot S., Scherrer M.J., Kägi G., Luft A.R., Gensicke H., Nederkoorn P., Tatlisumak T., Engelter S.T., Wegener S.
Working group(s)
Thrombolysis in Ischemic Stroke Patients (TRISP) Study Group
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
28/07/2020
Peer-reviewed
Oui
Volume
95
Number
4
Pages
e362-e373
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
To evaluate whether pretreatment with metformin (MET) is associated with less stroke severity and better outcome after IV thrombolysis (IVT), we analyzed a cohort of 1,919 patients with stroke with type 2 diabetes mellitus in a multicenter exploratory analysis.
Data from patients with diabetes and ischemic stroke treated with IVT were collected within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration. We applied propensity score matching (PSM) to obtain balanced baseline characteristics of patients treated with and without MET.
Of 1,919 patients with stroke with type 2 diabetes who underwent IVT, 757 (39%) had received MET before stroke (MET+), whereas 1,162 (61%) had not (MET-). MET+ patients were younger with a male preponderance. Hypercholesterolemia and pretreatment with statins, antiplatelets, or antihypertensives were more common in the MET+ group. After PSM, the 2 groups were well balanced with respect to demographic and clinical aspects. Stroke severity on admission (NIH Stroke Scale 10.0 ± 6.7 vs 11.3 ± 6.5), 3-month degree of independence on modified Rankin Scale (2 [interquartile range (IQR) 1.0-4.0] vs 3 [IQR 1.0-4.0]), as well as mortality (12.5% vs 18%) were significantly lower in the MET+ group. The frequency of symptomatic intracerebral hemorrhages did not differ between groups. HbA1c levels were well-balanced between the groups.
Patients with stroke and diabetes on treatment with MET receiving IVT had less severe strokes on admission and a better functional outcome at 3 months. This suggests a protective effect of MET resulting in less severe strokes as well as beneficial thrombolysis outcome.
Keywords
Aged, Diabetes Mellitus, Type 2/drug therapy, Female, Fibrinolytic Agents/therapeutic use, Humans, Hypoglycemic Agents/therapeutic use, Male, Metformin/therapeutic use, Middle Aged, Recovery of Function/drug effects, Retrospective Studies, Stroke/drug therapy, Stroke/mortality, Stroke/physiopathology, Thrombolytic Therapy/methods
Pubmed
Web of science
Create date
03/07/2020 16:23
Last modification date
14/03/2023 6:49
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