Association of prestroke metformin use, stroke severity, and thrombolysis outcome

Westphal, Laura P. and Widmer, Roni and Held, Ulrike and Steigmiller, Klaus and Hametner, Christian and Ringleb, Peter and Curtze, Sami and Martinez-Majander, Nicolas and Tiainen, Marjaana and Nolte, Christian H. and Scheitz, Jan F. and Erdur, Hebun and Polymeris, Alexandros A. and Traenka, Christopher and Eskandari, Ashraf and Michel, Patrik and Heldner, Mirjam R. and Arnold, Marcel and Zini, Andrea and Vandelli, Laura and Coutinho, Jonathan M. and Groot, Adrien E. and Padjen, Visnja and Jovanovic, Dejana R. and Bejot, Yannick and Brenière, Céline and Turc, Guillaume and Seners, Pierre and Pezzini, Alessandro and Magoni, Mauro and Leys, Didier and Gilliot, Sixtine and Scherrer, Michael J. and Kägi, Georg and Luft, Andreas R. and Gensicke, Henrik and Nederkoorn, Paul and Tatlisumak, Turgut and Engelter, Stefan T. and Wegener, Susanne and Thrombolysis in Ischemic Stroke Patients Study Group, . (2020) Association of prestroke metformin use, stroke severity, and thrombolysis outcome. Neurology, 95 (4). e362-e373.

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Official URL: https://edoc.unibas.ch/84720/

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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.
Faculties and Departments:03 Faculty of Medicine
UniBasel Contributors:Polymeris, Alexandros
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Lancet Publications
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 Nov 2021 13:03
Deposited On:24 Nov 2021 13:03

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