Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China; Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, PR China.
J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107927. doi: 10.1016/j.jstrokecerebrovasdis.2024.107927. Epub 2024 Aug 13.
We aimed to investigate the impact of metabolic syndrome (MetS) on the outcomes of stroke patients with large-artery atherosclerosis who underwent reperfusion therapy.
A retrospective analysis was carried out on patients receiving reperfusion therapy for atherothrombotic stroke between January 2019 and May 2021. MetS was diagnosed according to the AHA/NHLBI criteria. The primary outcome was the composite outcome of disability (modified Rankin Scale [mRS] score 3-5), death or stroke recurrence within 3 months of stroke onset. Secondary outcomes included disability and death within 3 months as well as hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) within 24 hours after reperfusion treatment. The independent association of MetS with the above outcomes and the highly correlated components of MetS was examined using binary logistic regression analysis.
A total of 174 patients were enrolled. MetS patients had a higher proportion of the composite outcome (p = 0.012), disability (p = 0.029) and HT (p = 0.049) than those without MetS, except for death (p = 0.375) and sICH (p = 0.306). Following adjustments, MetS remained independently associated with the composite outcome (adjusted OR, 3.011 [95 %CI 1.372-6.604]; p = 0.006) and disability (adjusted OR, 2.727 [95 %CI 1.220-6.098]; p = 0.015), but not HT (adjusted OR, 1.872 [95 %CI 0.854-4.104]; p = 0.117). Hypertriglyceridemia was remarkedly associated with the composite outcome (adjusted OR, 9.746 [95 % CI 2.402-39.536]; p = 0.001) and disability (adjusted OR, 6.966 [95 % CI 1.889-25.692]; p = 0.004).
MetS is independently associated with an increased risk of composite outcome and disability in patients with large-artery atherosclerosis stroke receiving reperfusion therapy, and hypertriglyceridemia is the main component that drives the effect of MetS on outcomes.
本研究旨在探讨代谢综合征（MetS）对接受再灌注治疗的大动脉粥样硬化性卒中患者结局的影响。
对 2019 年 1 月至 2021 年 5 月期间接受抗栓治疗的动脉粥样硬化性血栓性卒患者进行了回顾性分析。MetS 根据 AHA/NHLBI 标准进行诊断。主要结局为卒中发病后 3 个月内残疾（改良 Rankin 量表[mRS]评分 3-5）、死亡或卒中复发的复合结局。次要结局包括 3 个月内残疾和死亡以及再灌注治疗后 24 小时内的出血性转化（HT）和症状性颅内出血（sICH）。采用二元逻辑回归分析检查 MetS 与上述结局以及 MetS 的高度相关成分之间的独立关联。
共纳入 174 例患者。与无 MetS 患者相比，MetS 患者的复合结局（p = 0.012）、残疾（p = 0.029）和 HT（p = 0.049）的比例更高，而死亡（p = 0.375）和 sICH（p = 0.306）除外。校正后，MetS 仍与复合结局（校正 OR，3.011 [95 %CI 1.372-6.604]；p = 0.006）和残疾（校正 OR，2.727 [95 %CI 1.220-6.098]；p = 0.015）独立相关，但与 HT 无关（校正 OR，1.872 [95 %CI 0.854-4.104]；p = 0.117）。高甘油三酯血症与复合结局（校正 OR，9.746 [95 %CI 2.402-39.536]；p = 0.001）和残疾（校正 OR，6.966 [95 %CI 1.889-25.692]；p = 0.004）显著相关。
MetS 与接受再灌注治疗的大动脉粥样硬化性卒中患者的复合结局和残疾风险增加独立相关，高甘油三酯血症是导致 MetS 对结局影响的主要成分。
