- Prior metformin use in patients with type 2 diabetes (T2D) who have strokes may result in lower stroke severity, better functional outcome, and lower mortality after intravenous thrombolysis (IVT).
Why this matters
- Diabetes is a stroke risk factor and associated with more complications and less favorable clinical outcomes after thrombolysis.
- Data from 1919 patients with T2D affected by ischemic stroke and treated with IVT were collected within the European Thrombolysis in Ischemic Stroke Patients collaboration.
- Propensity score matching was applied to obtain balanced baseline characteristics of 757 patients treated with metformin (MET+) and 1162 without (MET−) prior to the stroke.
- Funding: Swiss National Science Foundation; UZH Filling the Gap Foundation; Boehringer Ingelheim.
- Mortality at 3 months in MET+ vs MET− groups was 12.5% vs 18.0% (P=.008).
- National Institutes of Health Stroke Scale score on admission was lower in MET+ vs MET− patients (10.0 vs 11.3; P<.001 as was median modified rankin scale after months vs respectively>
- No significant association found with MET dose.
- No differences in symptomatic intracerebral hemorrhages.
- Risk for bias from heterogeneity across centers.
- Potential for unmeasured confounders.