Background&Purpose: Experimental and retrospective clinical data have indicated that sulfonylurea drugs (SUD) may confer protection against cerebral swelling and hemorrhagic transformation in AIS. We sought to determine whether pretreatment and in-hospital use of SUD may be associated with better outcomes in diabetic AIS patients treated with IVT.
Subjects&Methods: We retrospectively analyzed prospectively collected data of consecutive AIS treated with IVT during a three-year period. Pre-treatment NIHSS, NIHSS at 48 hours and modified Rankin Scale (mRS) at discharge were documented. Symptomatic intracerebral hemorrhage (sICH) was defined as imaging evidence of ICH with NIHSS increase of 4 points within 72 hours. Early neurological improvement was defined as a NIHSS-score decrease of ≥4 points or a NIHSS-score of 0 at 48 hours. Cerebral edema was documented by neuroradiology reports. Favorable functional outcome (FFO) was defined as mRS of 0-1.
Results: A total of 148 diabetic AIS patients fulfilled the study inclusion criteria (mean age 64±11 years, 49% men, median admission NIHSS-score: 8 points). We identified 42 patients pre-treated with SUD (mean age 65±11 years, 50% men, median admission NIHSS-score: 8 points) all of whom continued to receive these medications during hospitalization. Demographic characteristics, vascular risk factors and admission NIHSS-scores did not differ (p>0.1) between patients pretreated (cases) and non-pretreated with SUD (controls). The prevalence of complications and favorable outcomes did not differ (p>0.1) between cases and controls: sICH (2% vs. 5%), cerebral edema (5% vs 4%), early neurological improvement (42% vs 43%), in-hospital mortality (12% vs 5%) and FFO (22% vs 32%).
Conclusions: Pretreatment and in-hospital use of SUD appears not to be associated with early favorable outcomes and lower likelihood of potential complications in diabetic AIS patients treated with IVT.