Smoking influences outcome in patients who had thrombolysed ischaemic stroke: the ENCHANTED study

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dc.contributor.authorSun, Lingli
dc.contributor.authorSong, Lili
dc.contributor.authorYang, Jie
dc.contributor.authorLindley, Richard I
dc.contributor.authorRobinson, Thompson
dc.contributor.authorLavados, Pablo
dc.contributor.authorDelcourt, Candice
dc.contributor.authorArima, Hisatomi
dc.contributor.authorOvbiagele, Bruce
dc.contributor.authorChalmers, John
dc.contributor.authorAnderson, Craig S
dc.contributor.authorWang, Xia
dc.date.accessioned2021-10-28T12:35:43Z
dc.date.available2021-10-28T12:35:43Z
dc.date.issued2021
dc.description.abstractBackground and purpose: As studies vary in defining the prognostic significance of smoking in acute ischaemic stroke (AIS), we aimed to determine the relation of smoking and key outcomes in patient participants who had thrombolysed AIS of the international quasi-factorial randomised Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: Post-hoc analyses of ENCHANTED, an international quasi-factorial randomised evaluation of intravenous alteplase-dose comparison and levels of blood pressure control in patients who had thrombolysed AIS. Multivariable logistic regression models with inverse probability of treatment weighting (IPTW) propensity scores were used to determine associations of self-reported smoking status and clinical outcomes, according to 90-day modified Rankin Scale (mRS) scores and symptomatic intracerebral haemorrhage (sICH). Results: Of 4540 patients who had an AIS, there were 1008 (22.2%) current smokers who were younger and predominantly male, with more comorbidities of hypertension, coronary artery disease, atrial fibrillation and diabetes mellitus, and greater baseline neurological impairment, compared with non-smokers. In univariate analysis, current smokers had a higher likelihood of a favourable shift in mRS scores (OR 0.88, 95% CI 0.77 to 0.99; p=0.038) but this association reversed in a fully adjusted model with IPTW (adjusted OR 1.15, 95% CI 1.04 to 1.28; p=0.009). A similar trend was also apparent for dichotomised poor outcome (mRS scores 2–6: OR 1.18, 95% CI 1.05 to 1.33; p=0.007), but not with the risk of sICH across standard criteria. Conclusion: Smoking predicts poor functional recovery in patients who had thrombolysed AIS.es
dc.identifier.citationStroke & Vascular Neurology 2021;6:e000493es
dc.identifier.urihttps://doi.org/10.1136/svn-2020-000493es
dc.identifier.urihttp://hdl.handle.net/11447/4959
dc.language.isoenes
dc.titleSmoking influences outcome in patients who had thrombolysed ischaemic stroke: the ENCHANTED studyes
dc.typeArticlees

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