Effect of smoking status on clinical outcomes after reperfusion therapy for acute ischemic stroke
Year: 2024
Type: article
Study design: Observational Study
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.
Source: Scientific Reports
Authors: Fumi Irie, Ryu Matsuo, Satomi Mezuki, Yoshinobu Wakisaka, Masahiro Kamouchi, Takanari Kitazono, Tetsuro Ago, the Fukuoka Stroke Registry Investigators, Takao Ishitsuka, Setsuro Ibayashi, Kenji Kusuda, Kenichiro Fujii, Tetsuhiko Nagao, Yasushi Okada, Masahiro Yasaka, Hiroaki Ooboshi, Takanari Kitazono, Katsumi Irie, Tsuyoshi Omae, Kazunori Toyoda, Hiroshi Nakane, Masahiro Kamouchi, Hiroshi Sugimori, Shuji Arakawa, Kenji Fukuda, Tetsuro Ago, Jiro Kitayama, Shigeru Fujimoto, Shoji Arihiro, Junya Kuroda, Yoshinobu Wakisaka, Yoshihisa Fukushima, Ryu Matsuo, Fumi Irie, Kuniyuki Nakamura, Takuya Kiyohara
Institutions: Kyushu University, Kyushu University Hospital, Fukuoka Mirai Hospital, Shonan Oiso Hospital, Japan Seafarers Relief Association, National Kyushu Medical Center, Fukuoka Hospital, Fukuoka Dental College Medical and Dental Hospital, Imazu Red Cross Hospital, National Cerebral and Cardiovascular Center, Fukuoka Higashi Medical Center, National Hospital Organization, Nippon Steel Yawata Memorial Hospital, St Mary's Hospital, Japanese Red Cross Fukuoka Hospital, Jichi Medical University, Kyushu Rosai Hospital
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,590
Awards: Establishment of a Foundation for Precision Stroke Medicine, Elucidation of prognostic factors associated with impairments in activities of daily living after stroke, Data-Driven Optimized Healthcare to Reduce the Burden of Stroke, G8831149760, Investigation of the Validity of Quality of Care Indicators and Development of a Clinical Database for Stroke Patients
OpenAlex ID: W4395043624