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Association of prestroke metformin use, stroke severity, and thrombolysis outcome
- Source :
- Neurology, 95(4), e362-e373. Lippincott Williams and Wilkins
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- ObjectiveTo 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.MethodsData 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.ResultsOf 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.ConclusionsPatients 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.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
610 Medicine & health
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Modified Rankin Scale
Internal medicine
Diabetes mellitus
Epidemiology
medicine
Humans
Hypoglycemic Agents
Thrombolytic Therapy
cardiovascular diseases
10064 Neuroscience Center Zurich
Stroke
Aged
Retrospective Studies
business.industry
Recovery of Function
10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Thrombolysis
Middle Aged
medicine.disease
Metformin
10040 Clinic for Neurology
3. Good health
2728 Neurology (clinical)
Diabetes Mellitus, Type 2
Propensity score matching
Cohort
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....41a92354e90d03aefcfc1b770a9a0b26