title: Intravenous Thrombolysis with Recombinant Tissue-type Plasminogen Activator for Acute Ischemic Stroke in Patients with Metabolic Syndrome.
abstract: BACKGROUND
  The metabolic syndrome (MetS) is common in patients with acute ischemic stroke (IS); however, its impact on outcome after intravenous thrombolysis (iv-thrombolysis) remains unclear. Thus, we aimed at evaluating the relationship between MetS and functional long-term outcome, mortality, and the presence of hemorrhagic complications in patients with IS treated with iv-thrombolysis.
  
  
  METHODS
  We retrospectively evaluated the demographic and clinical data of 535 Caucasian patients with acute IS who were consecutively treated with iv-thrombolysis from September 2006 to June 2013 in 2 experienced stroke centers in Poland. A favorable functional long-term outcome was defined as a modified Rankin scale score less than or equal to 2 points on day 90, and hemorrhagic complications were assessed with European Cooperative Acute Stroke Study criteria.
  
  
  RESULTS
  MetS was recognized in 192 (35.9%) patients (44.8% men; mean age, 70.8 ± 11.1 years), diabetes in 29.7%, dyslipidemia in 79.2%, and arterial hypertension in 75.5%. At 3 months, favorable outcome was found in 55.3% of patients, symptomatic intracerebral hemorrhage (SICH) in 18.3%, and 4.4 % of patients died. There was no difference regarding the presence of favorable outcome between patients with and without MetS (52.6% versus 56.9%, P = .34). The presence of SICH and 3-month mortality were more frequent in patients with MetS than without MetS (6.8% versus 2.9%, P = .03 and 23.4% versus 15.5%, P = .02, respectively); however, a multivariate analysis showed no impact of MetS on mortality or SICH.
  
  
  CONCLUSIONS
  Results of our study provide no data to suggest that the effect of intravenous tissue-type plasminogen activator differs based on the presence or absence of MetS.
authors.affiliation: Department of Neurology and Stroke Unit of Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland. Electronic address: piotrsobolewski@poczta.onet.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Sobolewski
authors.affiliation: Department of Neurology and Stroke Unit of Saint Luke's Hospital in Końskie, Końskie, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Brola
authors.affiliation: Department of Neurology and Stroke Unit of Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland.
authors.forename: Wiktor
authors.initials: W
authors.lastname: Szczuchniak
authors.affiliation: Department of Neurology and Stroke Unit of Saint Luke's Hospital in Końskie, Końskie, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Fudala
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kozera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008659:Metabolic Diseases / Q000150:complications*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Metabolic syndrome; acute ischemic stroke; intravenous thrombolysis; rt-PA