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Low TSH level predicts a poor clinical outcome in patients with anterior circulation ischemic stroke after endovascular thrombectomy

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Abstract

Objective

To determine the correlation of thyroid hormone status with hemorrhagic transformation (HT) and short-term clinical outcomes in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT)

Methods

A retrospective analysis was conducted on AIS patients who underwent EVT at our hospital from 2016 to 2019. Thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), and free thyroxine (FT4) levels were assessed, and logistic regression analyses were performed with HT incidence and functional outcome at 3 months.

Results

A total of 199 patients (148 males; mean age 62.9 ± 13.1 years) were included in the study. The number of patients with HT and unfavorable functional outcomes at 3 months were 74 (37.2%) and 129 (64.8%), respectively. Multiple logistic regression analysis showed that low TSH level (OR = 0.609; 95% CI 0.402–0.920, 푃 = 0.019) was an independent risk factor of poor functional outcome, while none of the thyroid hormones were significantly associated with HT risk. The optimal cutoff value of TSH that best distinguished both unfavorable outcome (sensitivity 31%, specificity 88.6%, area under the curve (AUC) 0.586) and mortality at 3 months (sensitivity 47.4%, specificity 78.3%, AUC 0.606) was 0.485 uIU/ml.

Conclusion

A lower TSH value upon admission may predict an unfavorable functional outcome in AIS patients after EVT, but thyroid hormone levels have no bearing on the risk of HT.

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Authors and Affiliations

  1. Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, ** District, Bei**g, 102200, China

    Yingbo Zhang

  2. Department of Neurology, The Bei**g Moslem People Hospital, No. 11, Youanmennei Street, **cheng District, Bei**g, 100054, China

    Yanbo He

  3. Department of Neurology, Liangxiang Hospital, No. 45 Gongchen North Street, Gongchen Street Office, Fangshan District, Bei**g, 102246, China

    Hongbo Chen

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  1. Zhongyun Chen
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  2. Yijia Sun
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Correspondence to Yingying Su.

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Our study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Xuan Wu Hospital.

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Chen, Z., Sun, Y., Zhang, Y. et al. Low TSH level predicts a poor clinical outcome in patients with anterior circulation ischemic stroke after endovascular thrombectomy. Neurol Sci 41, 1821–1828 (2020). https://doi.org/10.1007/s10072-020-04281-0

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