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. 2022 Mar 24:13:841484.
doi: 10.3389/fneur.2022.841484. eCollection 2022.

The Smoking Paradox in Stroke Patients Under Reperfusion Treatment Is Associated With Endothelial Dysfunction

Ramón Iglesias-Rey  1   2 , Antía Custodia  2   3 , Maria Luz Alonso-Alonso  1   2 , Iria López-Dequidt  4 , Manuel Rodríguez-Yáñez  4 , José M Pumar  1   5 , José Castillo  1   2 , Tomás Sobrino  2   3 , Francisco Campos  2 , Andres da Silva-Candal  2   6 , Pablo Hervella  1   2
Affiliations

The Smoking Paradox in Stroke Patients Under Reperfusion Treatment Is Associated With Endothelial Dysfunction

Ramón Iglesias-Rey et al. Front Neurol. .

Abstract

Objective: This study aimed to explore the association between smoking habit and the serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), in relation with the functional outcome of patients with acute ischemic stroke undergoing reperfusion treatment.

Methods: Observational and retrospective study of a series of patients with acute ischemic stroke subjected to reperfusion treatments. Clinical, analytical, and neuroimaging parameters were analyzed. The main endpoint was the functional outcome at 3 months, measured by the modified Ranking Scale (mRS). Logistic regression models were used to analyze the association between smoking and sTWEAK levels with functional outcome and leukoaraiosis.

Results: The results showed that smoking habit was associated with a good functional outcome at 3 months in patients with stroke (OR: 3.52; 95% CI: 1.03-11.9; p = 0.044). However, this independent association was lost after adjusting by sTWEAK levels (OR 1.73; 95% CI: 0.86-13.28; p = 0.116). sTWEAK levels were significantly lower in smoker patients [4015.5 (973.66-7921.83) pg/ml vs. 5,628 (2,848-10,202) pg/ml, p < 0.0001], while sTWEAK levels were significantly higher in patients with poor functional outcomes at 3 months [10,284 (7,388-13.247) pg/ml vs. 3,405 (2,329-6,629) pg/ml, p < 0.0001].

Conclusion: The decrease in sTWEAK levels was associated with a good functional outcome in smoker patients with stroke undergoing reperfusion therapy.

Keywords: endothelial dysfunction; leukoaraiosis; reperfusion; sTWEAK; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The Ranking scale distribution among smoker and non-smoker patients.
Figure 2
Figure 2
Distribution of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) values in non-smoker and smoker patient populations.
Figure 3
Figure 3
Basal sTWEAK concentrations at different points of the modified Rankin scale at 3 months in smoker and non-smokers patients.
Figure 4
Figure 4
sTWEAK concentrations in smoker and non-smoker patients who presented early neurological improvement and early neurological deterioration.
See this image and copyright information in PMC

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