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 Laura P., Widmer Roni, Held Ulrike, Steigmiller Klaus, Hametner Christian, Ringleb Peter, Curtze Sami, Martinez-Majander Nicolas, Tiainen Marjaana, Nolte Christian H., Scheitz Jan F., Erdur Hebun, Polymeris Alexandros A., Traenka Christopher, Eskandari Ashraf, Michel Patrik, Heldner Mirjam R., Arnold Marcel, Zini Andrea, Vandelli Laura, Coutinho Jonathan M., Groot Adrien E., Padjen Visnja, Jovanovic Dejana R., Bejot Yannick, Brenière Céline, Turc Guillaume, Seners Pierre, Pezzini Alessandro, Magoni Mauro, Leys Didier, Gilliot Sixtine, Scherrer Michael J., Kägi Georg, Luft Andreas R., Gensicke Henrik, Nederkoorn Paul, Tatlisumak Turgut, Engelter Stefan T., Wegener Susanne
ISSN
0028-3878
1526-632X
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
Publication Status: aheadofprint
Abstract
To evaluate whether pretreatment with metformin (MET) is associated with less stroke severity and better outcome after intravenous thrombolysis (IVT), we analyzed a cohort of 1919 stroke patients with type-2 diabetes in a multicenter exploratory analysis.
Data from patients with diabetes affected by 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 1919 stroke patients with type-2 diabetes who underwent IVT, 757 (39%) had received MET before stroke (MET+), whereas 1162 (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 two groups were well balanced with respect to demographic and clinical aspects. Stroke severity on admission (NIHSS 10.0 ± 6.7 vs. 11.3 ± 6.5), 3-months degree of independence on modified Rankin Scale (mRS): 2 [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 both groups.
Stroke patients with 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
Clinical Neurology
Pubmed
Web of science
Create date
03/07/2020 16:23
Last modification date
09/12/2020 6:26
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