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Zhang X, Gong P, Sheng L, Lin Y, Fan Q, Zhang Y, Bao Y, Li S, Du H, Chen Z, Ding C, Wang H, Xu P, Zhang M, Scalzo F, Liebeskind DS, Xie Y, Liu D. Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis. Aging (Albany NY) 2019; 11:6839-6850. [PMID: 31479421 PMCID: PMC6756908 DOI: 10.18632/aging.102215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/14/2019] [Indexed: 12/15/2022]
Abstract
Data regarding the association between subclinical thyroid dysfunction and clinical outcomes in ischemic stroke patients with intravenous thrombolysis (IVT) are limited. We aimed to investigate the predictive value of subclinical thyroid dysfunction in END, functional outcome and mortality at 3 months among IVT patients. We prospectively recruited 563 IVT patients from 5 stroke centers in China. Thyroid function status was classified as subclinical hypothyroidism, subclinical hyperthyroidism (SHyper) and euthyroidism. The primary outcome was END, defined as ≥ 4 point in the NIHSS score within 24 h after IVT. Secondary outcomes included 3-month functional outcome and mortality. Of the 563 participants, END occurred in 14.7%, poor outcome in 50.8%, and mortality in 9.4%. SHyper was an independent predictor of END [odd ratio (OR), 4.35; 95% confidence interval [CI], 1.86–9.68, P = 0.003], 3-month poor outcome (OR, 3.24; 95% CI, 1.43–7.33, P = 0.005) and mortality [hazard ratio, 2.78; 95% CI, 1.55–5.36, P = 0.003]. Subgroup analysis showed that there was no significant relationship between SHyper and clinical outcomes in IVT patients with endovascular therapy. In summary, SHyper is associated with increased risk of END, and poor outcome and mortality at 3 months in IVT patients without endovascular therapy.
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Affiliation(s)
- Xiaohao Zhang
- Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.,Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Pengyu Gong
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Sheng
- Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yanni Lin
- Department of Neurology, The First People's Hospital of Yulin, Yulin, Guangxi, China
| | - Qiqi Fan
- Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yun Zhang
- Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Yuanfei Bao
- Department of Neurology, The Third People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Shizhan Li
- Department of Neurology, The First People's Hospital of Yulin, Yulin, Guangxi, China
| | - Hongcai Du
- Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Zhonglun Chen
- Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Caixia Ding
- Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Huaiming Wang
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Pengfei Xu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Min Zhang
- Department of Endocrinology, Nanjing Xianlin Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Fabien Scalzo
- Department of Neurology, Neurovascular Imaging Research Core, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - David S Liebeskind
- Department of Neurology, Neurovascular Imaging Research Core, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Yi Xie
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Dezhi Liu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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