Chen Zhonglun, Su Mouxiao, Li Zhaokun, Du Hongcai, Zhang Shanshan, Pu Mingjun, Zhang Yun
Department of Neurology, MianYang Central Hospital, Mianyang, Sichuan 621000, People's Republic of China.
Neuropsychiatr Dis Treat. 2020 Sep 7;16:2045-2052. doi: 10.2147/NDT.S264300. eCollection 2020.
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).
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.
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, = 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, = 0.001). No significant findings were found in the association of MetS with sICH and mortality.
Our data demonstrated that MetS was associated with poor prognosis in acute ischemic patients treated with EVT.
代谢综合征（MetS）被认为会增加患心血管疾病的可能性。本研究旨在调查MetS是否可以预测血管内血栓切除术（EVT）后缺血性中风患者的预后。
前瞻性纳入2016年1月至2019年9月因前循环大血管闭塞接受EVT治疗的患者。入院后根据国际糖尿病联盟标准定义MetS。主要结局为3个月时预后不良（改良Rankin量表评分为3 - 6分）。次要结局包括有症状性颅内出血（sICH）和3个月时的死亡率。采用多变量逻辑回归模型评估MetS与临床结局之间的关系。
共纳入248例患者（平均年龄66.7岁；37.5%为女性），114例（46.0%）符合MetS标准。美国国立卫生研究院卒中量表评分中位数为15.0。131例（52.8%）患者在3个月时预后不良，其中26例（10.5%）发生sICH。3个月时的死亡率为19.0%（47/248）。在多变量分析中，MetS与预后不良显著相关（比值比[OR]为2.48；95%置信区间[CI]为1.29 - 4.78，P = 0.014）。预后不良的风险与MetS组分数量增加呈正相关（OR 1.78；95% CI 1.39 - 2.35，P = 0.001）。未发现MetS与sICH和死亡率之间存在显著关联。
我们的数据表明，MetS与接受EVT治疗的急性缺血性患者预后不良相关。
