Smoking compromises functional outcomes after acute ischaemic stroke

Acute ischaemic stroke patients who are current or recent smokers are at greater odds of having unfavourable functional outcomes 3 months after the index event, a study has found.

Researchers looked at 10,825 patients (mean age, 70.2 years; 37.0 percent female) with acute ischaemic stroke who had been independent before stroke onset. Of the patients, 4,396 (42.7 percent) had never smoked (nonsmokers), 3,328 (32.4 percent) were former smokers and 2,561 (24.9 percent) were current smokers.

Multivariable logistic regression analysis showed that compared with nonsmokers, current but not former smokers had poorer functional outcome (modified Rankin Scale score ≥2) at 3 months. The corresponding odds ratios (ORs) were 1.29 (95 percent confidence interval [CI], 1.11–1.49) and 1.05 (95 percent CI, 0.92–1.21).

Among the former smokers, those who quit smoking within 2 years of stroke onset had a higher likelihood of having poor functional outcome at 3 months relative to nonsmokers (OR, 1.75, 95 percent CI, 1.15–2.66). Of note, the odds of poor functional outcome tended to increase with greater number of daily cigarettes used (p-trend=0.002).

The same pattern of associations was observed for functional dependence (modified Rankin Scale score 2–5).

Given the findings, smoking cessation should be urged not only from the standpoint of averting the development or recurrence of stroke but also to improve poststroke functional restoration and outcome, according to the researchers.