Key result
Smoking paradoxically tracks with select post-treatment stroke gains but increases stroke and delirium risk.
Why the study?
The impact of smoking on stroke prognosis, including treatment response and long-term recovery, is complex and multifaceted, requiring comprehensive evaluation.
Does smoking status affect stroke prognosis and treatment efficacy in adult stroke patients?
Systematic Review (n=3,789)
Does smoking status affect stroke prognosis and treatment efficacy in adult stroke patients?
Despite paradoxical observations of improved outcomes in specific stroke treatment contexts such as endovascular therapy, smoking remains a major hazard for cerebrovascular disease and complications, reinforcing the necessity of targeted smoking cessation post-stroke.
Answers are grounded in this paper and cite their sources.
Smoking cessation remains essential despite select paradoxes; extends systematic evidence on smoking's mixed stroke associations.
Smoking is a well-established risk factor for stroke, yet its impact on stroke prognosis remains complex and multifaceted. This systematic review aims to elucidate the relationship between smoking and various stroke outcomes, including response to treatment and long-term recovery. We conducted a comprehensive analysis of four fundamental studies that examined the prognosis of stroke in smokers, focusing on clinical outcomes post-endovascular treatment, response to antiplatelet therapy, incidence of post-stroke delirium, and the effectiveness of thrombolysis treatment. The studies varied in design, including observational, retrospective, and post hoc trial analyses. The review reveals that smoking may paradoxically predict better clinical outcomes in specific treatment scenarios, such as post-endovascular treatment and when using clopidogrel. However, smokers also demonstrated higher rates of ischemic stroke and post-stroke delirium. Notably, the smoker's paradox in thrombolysis treatment was not supported. These findings highlight the need for personalized treatment approaches based on smoking status. Smoking has a complex and significant impact on stroke prognosis. While some benefits in specific treatment contexts were observed, the overall evidence strongly advises against smoking due to its adverse health consequences. This review underscores the importance of personalized stroke management in smokers and the integration of smoking cessation programs in post-stroke care. Future research should focus on larger, longitudinal studies to explore these associations further.
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Zafar et al. (2024) conducted a systematic review in Stroke (n=3,789). Smoking vs. Nonsmokers was evaluated on Stroke prognosis including post-endovascular treatment outcomes, response to antiplatelet therapy, post-stroke delirium incidence, and thrombolysis effectiveness. Smoking paradoxically predicted better outcomes in specific scenarios like post-endovascular treatment and clopidogrel use, but was associated with higher rates of stroke and post-stroke delirium.
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