Titre
Association of prestroke metformin use, stroke severity, and thrombolysis outcome.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Westphal, L.P.
Auteure/Auteur
Widmer, R.
Auteure/Auteur
Held, U.
Auteure/Auteur
Steigmiller, K.
Auteure/Auteur
Hametner, C.
Auteure/Auteur
Ringleb, P.
Auteure/Auteur
Curtze, S.
Auteure/Auteur
Martinez-Majander, N.
Auteure/Auteur
Tiainen, M.
Auteure/Auteur
Nolte, C.H.
Auteure/Auteur
Scheitz, J.F.
Auteure/Auteur
Erdur, H.
Auteure/Auteur
Polymeris, A.A.
Auteure/Auteur
Traenka, C.
Auteure/Auteur
Eskandari, A.
Auteure/Auteur
Michel, P.
Auteure/Auteur
Heldner, M.R.
Auteure/Auteur
Arnold, M.
Auteure/Auteur
Zini, A.
Auteure/Auteur
Vandelli, L.
Auteure/Auteur
Coutinho, J.M.
Auteure/Auteur
Groot, A.E.
Auteure/Auteur
Padjen, V.
Auteure/Auteur
Jovanovic, D.R.
Auteure/Auteur
Bejot, Y.
Auteure/Auteur
Brenière, C.
Auteure/Auteur
Turc, G.
Auteure/Auteur
Seners, P.
Auteure/Auteur
Pezzini, A.
Auteure/Auteur
Magoni, M.
Auteure/Auteur
Leys, D.
Auteure/Auteur
Gilliot, S.
Auteure/Auteur
Scherrer, M.J.
Auteure/Auteur
Kägi, G.
Auteure/Auteur
Luft, A.R.
Auteure/Auteur
Gensicke, H.
Auteure/Auteur
Nederkoorn, P.
Auteure/Auteur
Tatlisumak, T.
Auteure/Auteur
Engelter, S.T.
Auteure/Auteur
Wegener, S.
Auteure/Auteur
Groupes de travail
Thrombolysis in Ischemic Stroke Patients (TRISP) Study Group
Liens vers les personnes
Liens vers les unités
ISSN
1526-632X
Statut éditorial
Publié
Date de publication
2020-07-28
Volume
95
Numéro
4
Première page
e362
Dernière page/numéro d’article
e373
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
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.
PID Serval
serval:BIB_60D5FF42E716
PMID
Date de création
2020-07-03T15:23:27.904Z
Date de création dans IRIS
2025-05-20T17:11:00Z