Lipoic Acid Use and Functional Outcomes after Thrombolysis in Patients with Acute Ischemic Stroke and Diabetes.
BACKGROUND
Alpha-lipoic acid (aLA) is a strong antioxidant commonly used for treating diabetic polyneuropathy. Previously, we demonstrated the neurorestorative effects of aLA after cerebral ischemia in rats. However, its effects on patients with stroke remain unknown. We investigated whether patients treated with aLA have better functional outcomes after acute ischemic stroke (AIS) and reperfusion therapy than patients not receiving aLA.


METHODS
In this retrospective study of 172 prospectively registered patients with diabetes and AIS treated with tissue plasminogen activator (tPA), we investigated the relationship between aLA use and functional outcome both after 3 months and after 1 year. The functional outcomes included occurrence of hemorrhagic transformation (HT), early neurological deterioration (END), and early clinical improvement (ECI). Favorable outcomes were defined as modified Rankin Scale (mRS) scores of 0-2.


RESULTS
Of the 172 patients with AIS and diabetes, 47 (27.3%) used aLA. In the entire cohort, favorable outcomes occurred at significantly higher rates both at 3 months and at 1 year in those treated with aLA. The risks for END and HT were lower and the occurrence of ECI was higher in patients treated with aLA. In multivariable analysis, aLA use was associated with favorable outcomes both at 3 months and at 1 year. Age, HT, and increased National Institutes of Health Stroke Scale scores were negative predictors of a favorable outcome.


CONCLUSIONS
The use of aLA in patients with AIS and diabetes who are treated with tPA is associated with favorable outcomes. These results indicate that aLA could be a useful intervention for the treatment of AIS after reperfusion therapy.
Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.|Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Kang-Ho
KH
Choi
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Man-Seok
http://orcid.org/0000-0002-0637-5394
MS
Park
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Joon-Tae
JT
Kim
Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Korea.
Hyung-Seok
HS
Kim
Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Korea.
Ja-Hae
JH
Kim
Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Tai-Seung
TS
Nam
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Seong-Min
SM
Choi
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Seung-Han
SH
Lee
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Byeong-Chae
BC
Kim
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Myeong-Kyu
MK
Kim
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Ki-Hyun
KH
Cho
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