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Updated: Sep 27, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
The Smoking Paradox in Stroke Patients Under Reperfusion Treatment Is Associated With Endothelial Dysfunction
Ramón Iglesias-Rey1,2, Antía Custodia2,3, Maria Luz Alonso-Alonso1,2
1Neuroimaging and Biotechnology Laboratory, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Objective:
This study aimed to explore the association between smoking habit and the serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), in relation with the functional outcome of patients with acute ischemic stroke undergoing reperfusion treatment.
Methods:
Observational and retrospective study of a series of patients with acute ischemic stroke subjected to reperfusion treatments. Clinical, analytical, and neuroimaging parameters were analyzed. The main endpoint was the functional outcome at 3 months, measured by the modified Ranking Scale (mRS). Logistic regression models were used to analyze the association between smoking and sTWEAK levels with functional outcome and leukoaraiosis.
Results:
The results showed that smoking habit was associated with a good functional outcome at 3 months in patients with stroke (OR: 3.52; 95% CI: 1.03-11.9; p = 0.044). However, this independent association was lost after adjusting by sTWEAK levels (OR 1.73; 95% CI: 0.86-13.28; p = 0.116). sTWEAK levels were significantly lower in smoker patients [4015.5 (973.66-7921.83) pg/ml vs. 5,628 (2,848-10,202) pg/ml, p < 0.0001], while sTWEAK levels were significantly higher in patients with poor functional outcomes at 3 months [10,284 (7,388-13.247) pg/ml vs. 3,405 (2,329-6,629) pg/ml, p < 0.0001].
Conclusion:
The decrease in sTWEAK levels was associated with a good functional outcome in smoker patients with stroke undergoing reperfusion therapy.
