학술논문
Effect of smoking status on clinical outcomes after reperfusion therapy for acute ischemic stroke.
Document Type
Article
Author
Irie, Fumi; Matsuo, Ryu; Mezuki, Satomi; Wakisaka, Yoshinobu; Kamouchi, Masahiro; Kitazono, Takanari; Ago, Tetsuro; Ishitsuka, Takao; Ibayashi, Setsuro; Kusuda, Kenji; Fujii, Kenichiro; Nagao, Tetsuhiko; Okada, Yasushi; Yasaka, Masahiro; Ooboshi, Hiroaki; Irie, Katsumi; Omae, Tsuyoshi; Toyoda, Kazunori; Nakane, Hiroshi; Sugimori, Hiroshi
Source
Subject
*REPERFUSION
*ISCHEMIC stroke
*TREATMENT effectiveness
*SMOKING cessation
*SMOKING
*LOGISTIC regression analysis
*SUMATRIPTAN
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Language
ISSN
2045-2322
Abstract
Smoking has detrimental effects on the cardiovascular system; however, some studies have reported better clinical outcomes after thrombolysis for ischemic stroke in smokers than in nonsmokers, a phenomenon known as the smoking paradox. Therefore, this study aimed to examine the smoking paradox in patients with ischemic stroke receiving reperfusion therapy. Data were collected from a multicenter hospital-based acute stroke registry in Fukuoka, Japan. The 1148 study patients were categorized into current and noncurrent smokers. The association between smoking and clinical outcomes, including neurological improvement (≥ 4-point decrease in the National Institutes of Health Stroke Scale during hospitalization or 0 points at discharge) and good functional outcomes (modified Rankin Scale score of 0–2) at 3 months, was evaluated using logistic regression analysis and propensity score-matched analysis. Among the participants, 231 (20.1%) were current smokers. The odds ratios (ORs) of favorable outcomes after adjusting for potential confounders were not significantly increased in current smokers (OR 0.85, 95% confidence interval [CI] 0.60–1.22 for neurological improvement; OR 0.95, 95% CI 0.65–1.38 for good functional outcome). No significant association was found in the propensity score-matched cohorts. Smoking cessation is strongly recommended since current smoking was not associated with better outcomes after reperfusion therapy. [ABSTRACT FROM AUTHOR]