The effect of metabolic syndrome and obesity on outcomes of acute ischemic stroke patients treated with systemic thrombolysis

Metabolic syndrome (MetS) is associated with increased risk of ischemic stroke; while central obesity has controversial effects on ischemic stroke. We investigated effects of MetS and obesity on clinical courses and outcomes of patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA). 319 patients treated with intravenous thrombolysis were included to our study. Metabolic syndrome was determined if ≥ 3 of following criteria are present: elevated waist circumference; elevated triglycerides; reduced high density-lipoprotein cholesterol (HDL-C); elevated blood pressure; elevated fasting glucose. Obesity was defined as BMI ≥ 30. Clinical features at baseline, 24th hour and 3rd month were examined. Computed tomography (CT) findings for ASPECT scores and hemorrhagic transformation were analyzed. 182 patients were MetS +; they were older (p = 0.035), had similar ASPECT scores (p = 0.477) and NIHSS scores (p = 0.167) at admission; had significantly higher NIHSS scores at 24th hour (p < 0.001) and worse outcome at 3rd month (p < 0.001). Logistic regression analysis showed that either MetS, obesity or age were not independent predictors of poor outcome. Obese patients (n:72) had slight but significantly lower NIHSS scores at admission (p = 0.049) compared to non-obese patients; meanwhile there was no significant difference between NIHSS scores at 24th hour (p = 0.736) and 3rd month mRS scores (p = 0.145). Hemorrhagic transformation and mortality rates were not affected with MetS or obesity. MetS is not an independent factor on clinical outcome but its presence may have a relationship with poor outcome; but obesity was not found to have any significant role on clinical course and outcome of patients treated with iv rt-PA.