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Clinical Summary

Thyroid hormone levels may predict outcomes after acute stroke

Takeaway

  • Low serum free triiodothyronine (FT3) level upon admission is associated with a poor 3-month functional outcome and mortality in patients with acute stroke.
  • Finding suggests that serum FT3 on admission could predict long-term functional outcome and mortality following acute stroke.

Why this matters

  • Thyroid hormones are known risk factors for cerebrovascular disease and in recent years decrease in FT3 concentrations have been found in critical illness such as sepsis, myocardial infarction, and heart failure.

Study design

  • Retrospective analysis of 702 consecutive patients (good outcome, n=407; poor outcome, n=295) with acute stroke between October 2014 and December 2016.
  • Patients were assessed using National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS).
  • Funding: None disclosed.

Key results

  • Overall, mortality was observed in 58 patients.
  • Poor outcomes were associated with old age (P<.0001), low BMI (P<.0001), female sex (P<.0001), lower frequency of smoking (P=.0064), low glomerular filtration rate, higher NIHSS score on admission (P<.0001) and higher preadmission mRS score (P<.0001).
  • Number of patients with Afib (P=.0002), ischaemic heart disease (P<.0001) and prior stroke (P=.0298) was significantly higher in the poor outcome group vs good outcome group.
  • Low FT3 level (<2.00 pg/mL) was associated with poor functional outcome (OR, 3.16; 95% CI, 1.60-6.24) and mortality (OR, 2.55; 95% CI, 1.33-4.91) at 3 months after stroke onset.

Limitations

  • Serum thyroid hormones were evaluated only once.

References


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