Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy
Background: Evidence for the effect of subclinical thyroid dysfunction on the prognosis of patients suffering from acute ischemic stroke and receiving reperfusion therapy remains controversial. We aimed to investigate the association between subclinical thyroid dysfunction and the outcomes of patien...
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| Format: | Article |
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Frontiers Media S.A.
2019-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00782/full |
| _version_ | 1818055703681564672 |
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| author | Sang-Hwa Lee Min Uk Jang Yerim Kim So Young Park Chulho Kim Yeo Jin Kim Jong-Hee Sohn |
| author_facet | Sang-Hwa Lee Min Uk Jang Yerim Kim So Young Park Chulho Kim Yeo Jin Kim Jong-Hee Sohn |
| author_sort | Sang-Hwa Lee |
| collection | DOAJ |
| description | Background: Evidence for the effect of subclinical thyroid dysfunction on the prognosis of patients suffering from acute ischemic stroke and receiving reperfusion therapy remains controversial. We aimed to investigate the association between subclinical thyroid dysfunction and the outcomes of patients with acute ischemic stroke who were treated with reperfusion therapy.Methods: One hundred fifty-six consecutively recruited patients with acute ischemic stroke receiving reperfusion therapy (intravenous thrombolysis, intraarterial thrombectomy and combined intravenous thrombolysis and intraarterial thrombectomy) were included in this prospective observational study. We divided patients with subclinical thyroid dysfunction into the following 2 groups and defined a euthyroid group: subclinical hyperthyroidism (a thyroid-stimulating hormone level <0.35 μU/mL), subclinical hypothyroidism (a thyroid-stimulating hormone level >4.94 μU/mL), and a euthyroid state (0.35 μU/mL ≤ thyroid-stimulating hormone level ≤ 4.94 μU/mL). Patients with overt thyroid dysfunction were excluded. The primary outcome was functional disability at 3 months (modified Rankin Scale, mRS), and the secondary outcome was successful reperfusion. A multivariate analysis was performed to evaluate the associations between subclinical thyroid dysfunction and the primary and secondary outcomes.Results: The subclinical hyperthyroidism group appeared to have poor functional outcomes, but the differences were not significant. However, compared with patients in the euthyroid state, patients with subclinical hyperthyroidism had an increased risk of poor functional outcomes at 3 months after a stroke (adjusted odds ratio [OR] 2.50, 95% confidence interval [CI] 1.01–6.14 for a mRS score of 3 to 6) and a decreased rate of successful reperfusion after reperfusion therapy (OR 0.13, 95% CI 0.04–0.43).Conclusion: Subclinical hyperthyroidism may be independently associated with a poor prognosis at 3 months and unsuccessful reperfusion in patients with acute ischemic stroke receiving reperfusion therapy. |
| first_indexed | 2024-12-10T12:17:10Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T12:17:10Z |
| publishDate | 2019-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-2f2c4b6b88464af0a3f67344e488d95a2022-12-22T01:49:11ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-07-011010.3389/fneur.2019.00782471991Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion TherapySang-Hwa Lee0Min Uk Jang1Yerim Kim2So Young Park3Chulho Kim4Yeo Jin Kim5Jong-Hee Sohn6Department of Neurology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South KoreaDepartment of Neurology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, South KoreaDepartment of Neurology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, South KoreaDepartment of Endocrinology and Metabolism, Kyung Hee University Hospital, Seoul, South KoreaDepartment of Neurology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South KoreaDepartment of Neurology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South KoreaDepartment of Neurology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South KoreaBackground: Evidence for the effect of subclinical thyroid dysfunction on the prognosis of patients suffering from acute ischemic stroke and receiving reperfusion therapy remains controversial. We aimed to investigate the association between subclinical thyroid dysfunction and the outcomes of patients with acute ischemic stroke who were treated with reperfusion therapy.Methods: One hundred fifty-six consecutively recruited patients with acute ischemic stroke receiving reperfusion therapy (intravenous thrombolysis, intraarterial thrombectomy and combined intravenous thrombolysis and intraarterial thrombectomy) were included in this prospective observational study. We divided patients with subclinical thyroid dysfunction into the following 2 groups and defined a euthyroid group: subclinical hyperthyroidism (a thyroid-stimulating hormone level <0.35 μU/mL), subclinical hypothyroidism (a thyroid-stimulating hormone level >4.94 μU/mL), and a euthyroid state (0.35 μU/mL ≤ thyroid-stimulating hormone level ≤ 4.94 μU/mL). Patients with overt thyroid dysfunction were excluded. The primary outcome was functional disability at 3 months (modified Rankin Scale, mRS), and the secondary outcome was successful reperfusion. A multivariate analysis was performed to evaluate the associations between subclinical thyroid dysfunction and the primary and secondary outcomes.Results: The subclinical hyperthyroidism group appeared to have poor functional outcomes, but the differences were not significant. However, compared with patients in the euthyroid state, patients with subclinical hyperthyroidism had an increased risk of poor functional outcomes at 3 months after a stroke (adjusted odds ratio [OR] 2.50, 95% confidence interval [CI] 1.01–6.14 for a mRS score of 3 to 6) and a decreased rate of successful reperfusion after reperfusion therapy (OR 0.13, 95% CI 0.04–0.43).Conclusion: Subclinical hyperthyroidism may be independently associated with a poor prognosis at 3 months and unsuccessful reperfusion in patients with acute ischemic stroke receiving reperfusion therapy.https://www.frontiersin.org/article/10.3389/fneur.2019.00782/fullsubclinical thyroid dysfunctionsubclinical hyperthyroidismpoor outcomereperfusion therapyacute ischemic stroke |
| spellingShingle | Sang-Hwa Lee Min Uk Jang Yerim Kim So Young Park Chulho Kim Yeo Jin Kim Jong-Hee Sohn Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy Frontiers in Neurology subclinical thyroid dysfunction subclinical hyperthyroidism poor outcome reperfusion therapy acute ischemic stroke |
| title | Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy |
| title_full | Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy |
| title_fullStr | Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy |
| title_full_unstemmed | Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy |
| title_short | Subclinical Hyperthyroidism Could Predict Poor Outcomes in Patients With Acute Ischemic Stroke Treated With Reperfusion Therapy |
| title_sort | subclinical hyperthyroidism could predict poor outcomes in patients with acute ischemic stroke treated with reperfusion therapy |
| topic | subclinical thyroid dysfunction subclinical hyperthyroidism poor outcome reperfusion therapy acute ischemic stroke |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00782/full |
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