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The smoking paradox in ischemic stroke patients treated with intra-arterial thrombolysis in combination with mechanical thrombectomy–VISTA-Endovascular

Author

Listed:
  • Anna Kufner
  • Huma Fatima Ali
  • Martin Ebinger
  • Jochen B Fiebach
  • David S Liebeskind
  • Matthias Endres
  • Bob Siegerink
  • on behalf of the VISTA-Endovascular Collaborators

Abstract

Background: The smoking-paradox of a better outcome in ischemic stroke patients who smoke may be due to increased efficacy of thrombolysis. We investigated the effect of smoking on outcome following endovascular therapy (EVT) with mechanical thrombectomy alone versus in combination with intra-arterial (IA-) thrombolysis. Methods: The primary endpoint was defined by three-month modified Rankin Scale (mRS). We performed a generalized linear model and reported relative risks (RR) for smoking (adjustment for age, sex, hypertension, atrial fibrillation, stroke severity, time to EVT) in patient data stemming from the Virtual International Stroke Trials Archive—Endovascular database. Results: Among 1,497 patients, 740(49.4%) were randomized to EVT; among EVT patients, 524(35.0%) received mechanical thrombectomy alone and 216(14.4%) received it in combination with IA-thrombolysis. Smokers (N = 396) had lower mRS scores (mean 2.9 vs. 3.2; p = 0.02) and mortality rates (10% vs. 17.3%; p

Suggested Citation

  • Anna Kufner & Huma Fatima Ali & Martin Ebinger & Jochen B Fiebach & David S Liebeskind & Matthias Endres & Bob Siegerink & on behalf of the VISTA-Endovascular Collaborators, 2021. "The smoking paradox in ischemic stroke patients treated with intra-arterial thrombolysis in combination with mechanical thrombectomy–VISTA-Endovascular," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-11, May.
    • Handle: RePEc:plo:pone00:0251888
    DOI: 10.1371/journal.pone.0251888
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