Abstract Details

Title Nicotine Dependence and Outcomes Following Intravenous and Intra-Arterial Thrombolytic Treatment in Acute Ischemic Stroke Patients

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 270

Objective

Background BACKGROUND: Nicotine dependence is highly prevalent among patients with acute ischemic stroke and may be associated with lower rates of post-thrombolytic ICH.

Design/Methods DESIGN/METHODS: We obtained data from NIS between 2004 to 2009 with a primary diagnosis of ischemic stroke and received IV and/or IA thrombolytics. We identified patients with nicotine dependence and compared the rates of ICH and outcomes with those without nicotine dependence. Outcomes were classified as minimal disability, moderate to severe disability, and death based on discharge disposition.

Results RESULTS: Of the 85,115 acute ischemic stroke patients who received IV or IA thrombolytics, 13,814 (16%) patients had nicotine dependence. The average age of patients with nicotine dependence was 58.4±26 versus 70.4±34 years and lower proportion of women (37.4% versus 50.3%). The odds of ICH (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.1-1.6, p value=0.03) and in-hospital mortality [OR 1.3, 95% CI 1.1-1.6, p value=0.0006] were significantly higher among patients without nicotine dependence after adjusting for potential confounders. The rates of favorable outcomes at discharge were significantly lower among non-nicotine dependant patients [OR 0.8, 95% CI 0.07-0.9, p value=0.0005]. In the subset analysis of IA thrombolytic treated patients, nicotine dependent patients had a non-significant decreased risk of any ICH [OR 0.7, 95% CI 0.5-1.2, p value=0.2] and in-hospital mortality [OR 0.8, 95% CI 0.6-1.1, p value=0.1]. The rates of favorable outcomes at discharge were significantly higher for nicotine dependance patients [OR 1.4, 95% CI 1.1-1.7, p value=0.003].

Conclusions CONCLUSIONS: There seems to be a decreased risk of poor outcomes, ICH, and death among nicotine dependant acute ischemic stroke patients receiving thrombolytics. Single dose nicotine administration in patients receiving thrombolytics maybe considered as a therapeutic option.

Authors/Disclosures
PRESENTER	No disclosure on file
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
	No disclosure on file
Victoria A. Parada, MD (Valley Institute of Neulogical Excellence)	No disclosure on file
Haralabos Zacharatos, MD	Dr. Zacharatos has nothing to disclose.
Mikayel Grigoryan, MD (Axon Neurology)	Dr. Grigoryan has nothing to disclose.
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
Wondwossen G. Tekle, MD	Dr. Tekle has nothing to disclose.
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Christopher Scherfler, MD (PET Neurology)	No disclosure on file

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