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Research Paper|Volume 11, Issue 17|pp 6839—6850

Prognostic value of subclinical thyroid dysfunction in ischemic stroke patients treated with intravenous thrombolysis

Xiaohao Zhang1,2, Pengyu Gong3, Lei Sheng1, Yanni Lin4, Qiqi Fan1, Yun Zhang5, Yuanfei Bao6, Shizhan Li4, Hongcai Du5, Zhonglun Chen5, Caixia Ding1, Huaiming Wang2, Pengfei Xu2, Min Zhang7, Fabien Scalzo8, David S. Liebeskind8, Yi Xie2, Dezhi Liu9
  • 1Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
  • 2Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
  • 3Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
  • 4Department of Neurology, The First People’s Hospital of Yulin, Yulin, Guangxi, China
  • 5Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, China
  • 6Department of Neurology, The Third People’s Hospital of Nantong, Nantong, Jiangsu, China
  • 7Department of Endocrinology, Nanjing Xianlin Drum Tower Hospital, Nanjing, Jiangsu, China
  • 8Department of Neurology, Neurovascular Imaging Research Core, University of California Los Angeles, Los Angeles, CA 90095, USA
  • 9Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
* Equal contribution
Received: June 7, 2019Accepted: August 14, 2019Published: September 3, 2019
https://doi.org/10.18632/aging.102215

Copyright © 2019 Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Data regarding the association between subclinical thyroid dysfunction and clinical outcomes in ischemic stroke patients with intravenous thrombolysis (IVT) are limited. We aimed to investigate the predictive value of subclinical thyroid dysfunction in END, functional outcome and mortality at 3 months among IVT patients. We prospectively recruited 563 IVT patients from 5 stroke centers in China. Thyroid function status was classified as subclinical hypothyroidism, subclinical hyperthyroidism (SHyper) and euthyroidism. The primary outcome was END, defined as ≥ 4 point in the NIHSS score within 24 h after IVT. Secondary outcomes included 3-month functional outcome and mortality. Of the 563 participants, END occurred in 14.7%, poor outcome in 50.8%, and mortality in 9.4%. SHyper was an independent predictor of END [odd ratio (OR), 4.35; 95% confidence interval [CI], 1.86–9.68, P = 0.003], 3-month poor outcome (OR, 3.24; 95% CI, 1.43–7.33, P = 0.005) and mortality [hazard ratio, 2.78; 95% CI, 1.55–5.36, P = 0.003]. Subgroup analysis showed that there was no significant relationship between SHyper and clinical outcomes in IVT patients with endovascular therapy. In summary, SHyper is associated with increased risk of END, and poor outcome and mortality at 3 months in IVT patients without endovascular therapy.