Risk Factors Associated With Exclusion of Obese Patients Ischemic Stroke With a History of Smoking From Thrombolysis Therapy.

Autor:	Brewer PC; Department of Biomedical Sciences, University of South Carolina, School of Medicine-Greenville, Greenville, SC, USA., Ojo DT; Department of Biomedical Sciences, University of South Carolina, School of Medicine-Greenville, Greenville, SC, USA., Broughton PX; Department of Biomedical Sciences, University of South Carolina, School of Medicine-Greenville, Greenville, SC, USA., Imeh-Nathaniel A; Department of Biology, North Greenville University, Tigerville, SC, USA., Imeh-Nathaniel S; Department of Biology, North Greenville University, Tigerville, SC, USA., Nathaniel TI; Department of Biomedical Sciences, University of South Carolina, School of Medicine-Greenville, Greenville, SC, USA.
Jazyk:	angličtina
Zdroj:	Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis [Clin Appl Thromb Hemost] 2024 Jan-Dec; Vol. 30, pp. 10760296241246264.
DOI:	10.1177/10760296241246264
Abstrakt:	The objective of this study is to determine risk factors that may contribute to exclusion decision from recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke (AIS) with a combined current or history of smoking and obesity. This study was conducted on data from 5469 patients with AIS collected from a regional stroke registry. Risk factors associated with inclusion or exclusion from rtPA were determined using multivariate logistic regression analysis. The adjusted odds ratios and 95% confidence interval for each risk factor were used to predict the increasing odds of an association of a specific risk factor with exclusion from rtPA. In the adjusted analysis, obese patients with AIS with a history of smoking (current and previous) excluded from rtPA were more likely to present with carotid artery stenosis (OR = 0.069, 95% CI 0.011-0.442), diabetes (OR = 0.604, 95% CI 0.366-0.997), higher total cholesterol (OR = 0.975, 95% CI 0.956-0.995), and history of alcohol use (OR = 0.438, 95% CI 0.232-0.828). Higher NIHSS score (OR = 1.051, 95% CI 1.017-1.086), higher triglycerides (OR = 1.004, 95% CI 1.001-1.006), and higher high-density lipoprotein (OR = 1.028, 95% CI 1.000-1.057) were associated with the inclusion for rtPA. Our findings reveal specific risk factors that contribute to the exclusion of patients with AIS with a combined effect of smoking and obesity from rtPA. These findings suggest the need to develop management strategies to improve the use of rtPA for obese patients with AIS with a history of smoking. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu