Key result
High degrees of acute endocrine and metabolic alterations at admission were independently associated with a poor one-year functional prognosis in patients with acute ischemic stroke (adjusted OR 4.231, P=0.001).
Why the study?
Post-stroke stress can trigger instant survival, but its influence on long-term ischemic stroke outcomes remains controversial.
Do acute endocrine and metabolic variations (fT3 and SHR) predict poor long-term prognosis in patients with acute ischemic stroke?
Cohort (n=887)
No
Do acute endocrine and metabolic variations (fT3 and SHR) predict poor long-term prognosis in patients with acute ischemic stroke?
Odds Ratio: 4.231
p-value: p=0.001
High degrees of acute post-stroke stress, indicated by low fT3 and high SHR, are strongly associated with poor one-year functional outcomes in acute ischemic stroke patients.
Acute post-stroke endocrine stress markers identify higher 1-year risk; leaves open whether interventions improve prognosis.
BACKGROUND: Post-stroke stress can trigger instant survival but its influence on long-term ischemic stroke outcomes remains controversial. Thus, we sought to explore the associations of acute post-stroke stress evidenced by endocrine and metabolic changes, with long-term ischemic stroke outcomes. METHODS: Admissions for acute ischemic stroke within seven days of onset were prospectively recruited to determine acute endocrine and metabolic variations measured by thyroid parameters and the stress hyperglycemia ratio (SHR). Long-term ischemic stroke prognoses were followed up for one year, with the primary outcome being a modified Rankin Scale score of 3 to 6. RESULTS: A total of 887 patients were enrolled, of which 535 reached the final one-year followed up at a poor prognosis rate of 29.3%. Patients with poor outcomes were observed to have lower levels of free triiodothyronine (fT3) and higher levels of SHR on admission. Medium values (fT3, 4.4 mmol/L; SHR, 8 nmol/L) were used to divide patients into four gradient stress degrees. Larger acute endocrine and metabolic variations (fT3 < 4.4 mmol/L and SHR ≥ 8 nmol/L) were independently associated with a poor one-year prognosis (adjusted OR = 4.231, P = 0.001). CONCLUSIONS: High degrees of acute post-stroke stress may aggravate long-term ischemic stroke prognosis and timely stress-reduced interventions may help promote post-stroke living quality is equally important as survival.
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Pang et al. (2024) conducted a cohort in Acute ischemic stroke (n=887). High acute endocrine and metabolic alterations (fT3 < 4.4 pmol/L and SHR ≥ 8 nmol/L) vs. Low acute endocrine and metabolic alterations (fT3 ≥ 4.4 pmol/L and SHR < 8 nmol/L) was evaluated on Modified Rankin Scale score of 3 to 6 at 1 year (OR 4.231, p=0.001). High degrees of acute endocrine and metabolic alterations at admission were independently associated with a poor one-year functional prognosis in patients with acute ischemic stroke (adjusted OR 4.231, P=0.001).
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