Comorbidities Related to Clinical Outcomes in Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy: Review of Literature and Experience at a Single Comprehensive Stroke Center

Abstract

Background: Recent clinical trials have shown mechanical thrombectomy (MT) to have clinical benefit for patients with acute ischemic stroke. The purpose of this study was to identify comorbid conditions that correlate with functional nonindependence in patients with acute ischemic stroke who underwent MT at a single comprehensive stroke center. Methods: Patients who had multiphase computed tomography angiography (MCTA) and subsequently underwent MT were included in this study. The modified Rankin Scale (mRS) scores at baseline (prestroke) and at 90 days were established by reviewing patients' histories and medical record documentation. Comorbid conditions were obtained from electronic medical records. Multivariate analysis was performed for body mass index, chronic hypertension, diabetes, hemoglobin A1c, peripheral artery disease, and hyperlipidemia to determine the impact of comorbidities on functional outcome. Age was analyzed using linear regression. Functional independence was defined as an mRS score of 0-2, and functional nonindependence was defined as an mRS score >2. Results: During the study period, 721 patients underwent MCTA, and 134 patients were included for MT. Patients with chronic hypertension and peripheral artery disease showed a statistically significant association with functional nonindependence at 90 days (P=0.005 and P=0.0125, respectively). Younger age at presentation was correlated with functional nonindependence using linear regression (P=0.0001). Conclusion: Hypertension, peripheral artery disease, and younger age at presentation are correlated with poor functional outcome in patients with acute ischemic stroke undergoing MT.

JNK pathway‐associated phosphatase in acute ischemic stroke patients: Its correlation with T helper cells, clinical properties, and recurrence risk

“… 1 , 2 Many AIS patients have one or more comorbidities, including hypertension, diabetes mellitus, hyperlipidemia, etc., which increase the mortality rate of AIS. 3 , 4 In addition, due to the narrow therapeutic time window that limits the therapeutic application, only a minority of AIS patients benefit from the timely effective AIS treatment methods. 5 , 6 In order to extend treatment application and improve AIS management, there is a need to find out novel biomarkers to assist identify early and monitoring of the prognosis of AIS patients.…”

“…Acute ischemic stroke (AIS) serves as the most common cause of disability and mortality, that accounts for 5.5 million deaths annually 1,2 . Many AIS patients have one or more comorbidities, including hypertension, diabetes mellitus, hyperlipidemia, etc., which increase the mortality rate of AIS 3,4 . In addition, due to the narrow therapeutic time window that limits the therapeutic application, only a minority of AIS patients benefit from the timely effective AIS treatment methods 5,6 .…”

Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke

“…Chronic hypertension is a well-known risk factor for worse outcomes in stroke patients. According to a review by Noor et al, hypertension, peripheral artery disease, and younger age correlate with poor functional outcomes in patients undergoing EVT [ 36 ]. Furthermore, Alobaida et al concluded that atrial fibrillation was also linked to a worse functional recovery but not with intracerebral hemorrhage or a higher death rate [ 37 ].…”