Patients with metabolic syndrome are more likely to experience resistance to thrombolysis in middle cerebral artery (MCA) ischemic stroke, according to a report in the July 15th Neurology.
Metabolic syndrome has been shown to be an independent risk factor for ischemic stroke, the authors explain, but its potential impact on acute ischemic stroke prognosis has not been carefully evaluated.
For the present study, Dr. Juan F. Arenillas from Germans Trias i Pujol Universitary Hospital in Barcelona, Spain, and colleagues conducted such an evaluation, in patients with and without metabolic syndrome who underwent thrombolysis with tissue plasminogen activator for acute MCA ischemic stroke.
Although metabolic syndrome did not appear to influence initial stroke severity, clots were more often resistant to lysis in patients with metabolic syndrome (41 per cent) than in those without (11 per cent).
In addition, patients without metabolic syndrome were more likely to recanalize fully than were patients with metabolic syndrome (81 per cent versus 43 per cent, respectively). Furthermore, at 24 hours after tPA administration, 57 per cent of patients with metabolic syndrome had failed to recanalize fully, the investigators say, compared with only 19 per cent of patients without metabolic syndrome.
Metabolic syndrome was independently associated with poor clinical outcome and a larger infarct volume in patients with atherothrombotic stroke, according to the researchers.
"The metabolic syndrome may not be only associated with an increased risk for incident and recurrent ischemic stroke, as previously known, but also with a poor response to thrombolytic therapy in patients with acute ischemic stroke," the authors conclude.
Neurology 2008;71:190-195
