Takeaway
- Risk for less favourable neurological outcomes at 90 days after the index stroke was higher in patients with ischaemic stroke who had peptic ulcer.
- Patients with peptic ulcer showed increased inflammation, which may contribute to poor prognosis of ischaemic stroke.
Why this matters
- Existing evidence suggests an association between peptic ulcers and increased risk for ischaemic stroke.
- However, evidence regarding the effect of peptic ulcer on functional outcomes of ischaemic stroke is limited.
Study design
- 2577 patients with first-ever ischaemic stroke diagnosed within 7 days of onset were evaluated.
- National Institute of Health Stroke Scale (NIHSS) assessed stroke severity at admission and modified Rankin scale (mRS) assessed functional neurological outcomes at 90 days (score of 0-2 depicted favourable functional outcome).
- Funding: None disclosed.
Key results
- Of the patients enrolled, 129 (5.0%) were identified with and 2448 (95.0%) without a history of peptic ulcer before the index stroke.
- Patients with vs without peptic ulcer had a lower favourable functional outcome (mRS [0-2], 42.6% vs 59.3%; P<.001) and higher overall mortality (5.4% vs 1.6%; P=.001) at 90 days.
- Peptic ulcer history (OR, 2.89; P=.043), NIHSS score (OR, 2.11; P<.001) and large-artery atherosclerosis stroke subtype (OR, 4.08; P=.035) were associated with decreased likelihood of favourable neurological outcomes.
- Percentage of neutrophil (67.2% vs 64.3%; P=.012) and levels of serum C-reactive protein (15.6 vs 9.9 mg/L; P=.001) were higher in patients with peptic ulcer.
Limitations
- Peptic ulcer history confirmed retrospectively.
- Presence of active peptic ulcer at the time of admission not determined.
References
References
