<p>Metabolic Syndrome Predicts Poor Outcome in Acute Ischemic Stroke Patients After Endovascular Thrombectomy</p>

Abstract

Background and Aims The metabolic syndrome (MetS) is believed to contribute to a higher probability of developing cardiovascular diseases. This study aimed to investigate whether MetS could predict the prognosis in ischemic stroke patients after endovascular thrombectomy (EVT). Methods Between January 2016 and September 2019, patients treated with EVT due to large vessel occlusions in anterior circulation were prospectively recruited. MetS was defined using the International Diabetes Federation criteria after admission. The primary outcome was a 3-month poor outcome (modified Rankin scale score of 3–6). Secondary outcomes included symptomatic intracranial hemorrhage (sICH) and mortality at 3 months. Multivariable logistic regression models were used to assess the relationship between MetS and clinical outcomes. Results A total of 248 patients were enrolled (mean age, 66.7 years; 37.5% female) and 114 (46.0%) met with the MetS criteria. The median National Institutes of Health Stroke Scale score was 15.0. There were 131 (52.8%) patients achieving the poor outcome at 3 months, among which 26 (10.5%) patients developed sICH. The mortality at 3 months was 19.0% (47/248). In multivariable analysis, MetS was significantly correlated to poor outcome (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.29–4.78, P = 0.014). The risk for poor outcome was positively associated with the increased number of MetS components (OR 1.78; 95% CI 1.39–2.35, P = 0.001). No significant findings were found in the association of MetS with sICH and mortality. Conclusion Our data demonstrated that MetS was associated with poor prognosis in acute ischemic patients treated with EVT.

Obesity and Stroke: Does the Paradox Apply for Stroke?

“…72 However, these results are not always reproducible as seen in Bouslama et al 73 (n=926), which could not find an association between BMI and outcomes after mechanical thrombectomy due to large vessel occlusive acute ischemic stroke. Also, Chen et al 74 (n=248) reported that metabolic syndrome (which measures obesity according to waist circumference) was associated with increased risk of unfavorable functional outcome at 90 days in ischemic stroke treated with endovascular treatment, but was not associated with mortality. However, this study had a small sample size and metabolic derangement ascribed to metabolic syndrome had a stronger influence on outcomes more than pure obesity.…”

Associations between basic physiological observations recorded pre-thrombectomy and functional outcome: a systematic review and meta-analysis

“…higher pre-thrombectomy blood/serum glucose was significantly associated with an unfavourable functional outcome: WMD = 1.34 mmol/L (95%CI 0.97 to 1.72; Z = 12.3) p < 0.00001 (Figure 2). Most [N = 13/19 (68%)] individual studies reported significantly higher glucose in unfavourable outcome groups (Shi et al, 2014;Jiang et al, 2015;Ozdemir et al, 2015;Zi et al, 2017;Kim et al, 2018;Huo et al, 2019;Sallustio et al, 2019;Wu et al, 2019;Broocks et al, 2020;Chen et al, 2020;Suissa et al, 2020;Nisar et al, 2021;Sun et al, 2021) (Supplementary Table S6), including the highest weighted study [ (Zi et al, 2017); N = 698], although the WMD was not large. This was the case for most high weighted studies, apart from Chen et al (2020).…”

“…Most [N = 13/19 (68%)] individual studies reported significantly higher glucose in unfavourable outcome groups (Shi et al, 2014;Jiang et al, 2015;Ozdemir et al, 2015;Zi et al, 2017;Kim et al, 2018;Huo et al, 2019;Sallustio et al, 2019;Wu et al, 2019;Broocks et al, 2020;Chen et al, 2020;Suissa et al, 2020;Nisar et al, 2021;Sun et al, 2021) (Supplementary Table S6), including the highest weighted study [ (Zi et al, 2017); N = 698], although the WMD was not large. This was the case for most high weighted studies, apart from Chen et al (2020). Shriki et al (2020) and Karamchandani et al (2022) displayed non-significant differences in the opposite direction but were small, low weighted studies.…”

“…Figure 4 demonstrates that higher admission SBP had a small, significant association with unfavourable functional outcome: WMD = 2.98 mmHg (95%CI 0.86 to 5.11, Z = 2.75), p = 0.006. Reflected in the forest plot, four highly weighted studies and one low weighted study demonstrated a small but significant difference in outcome (Jiang et al, 2015;Goyal et al, 2017;Cho et al, 2019;Chen et al, 2020;Sun et al, 2021) (Supplementary Table S7). However, this small effect was not evenly distributed across studies and the highest weighted studies (Anadani et al, 2019;Diprose et al, 2020;Lin et al, 2022a), reported non-significant associations (Supplementary Table S7).…”

Neuroprotective Effect of Polyherbal Recipe Containing Ginger, Chinese Date, and Wood Ear Mushroom against Ischemic Stroke with Metabolic Syndrome Condition via Epigenetic Modification of Inflammation and Oxidative Stress

“…It has been reported that stroke with MetS shows poor prognosis. In addition, stroke survivors with MetS also show the higher mortality rate and stroke recurrence than those without MetS [6]. Since stroke produces a great socioeconomic burden and the current therapeutic strategy is still limited, it is very essential to prevent it [7].…”