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Favorable functional outcomes in acute ischemic stroke patients with subclinical hypothyroidism.
MedLine Citation:
PMID:  21715712     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the protective effects of subclinical hypothyroidism (SCH) on ischemic stroke severity and its functional outcome. METHODS: Seventy-three consecutive patients admitted for first-ever cerebral ischemic stroke who met the inclusion criteria of this study were included. Serum thyroid-stimulating hormone (TSH) levels were measured for all patients. Stroke severity was recorded for each patient on admission using the NIH Stroke Scale. The patients were followed, and their functional outcomes were evaluated at 1 and 3 months after stroke using the modified Rankin Scale (mRS) and the Barthel Index. All values were compared between patients with and without SCH (serum TSH in the range of 2.5-10 mIU/L, with normal thyroid function test results). RESULTS: Of the patients, 49 (67.1%) had normal serum TSH, and 24 (32.8%) had SCH. Patients with higher levels of serum TSH tended to have a milder stroke on admission with a significantly better outcome, described as a mRS score of 0 or 1, at 1 (p = 0.029) and 3 (p = 0.048) months of follow-up. Mortality was also found to be lower in the group of patients with SCH (p = 0.008, at 3 months of follow-up). CONCLUSIONS: This study showed a significant protective association of SCH with better outcomes and lower mortality after cerebral ischemic stroke. Possible explanations for this association are ischemic preconditioning, reduced adrenergic tone, and hypometabolic state.
Authors:
Fahimeh H Akhoundi; Askar Ghorbani; Akbar Soltani; Alipasha Meysamie
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-29
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Departments of Neurology (F.H.A., A.G.) and Endocrinology and Metabolism Research Center (A.S.), Shariati Hospital, and Department of Community Medicine (A.M.), Tehran University of Medical Sciences, Tehran, Iran.
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