Association of pre-stroke metformin use, stroke severity, and thrombolysis outcome

So that brings up an immediate question. 'Should metformin be immediately given to stroke patients as part of their hyperacute therapy?'  WHOM will answer that question? Specific names needed. You can see the fucking incompetence of all the stroke medical world in that nothing seems to have been done with this in the past 4.5 years.

You could stay forever young (or young for a long time) with this diabetes drug 

Dec. 2015

In this one is this line:The drug, which is cheaply available for just $0.16 a day, works by boosting the number of oxygen molecules released into a cell, which in turn seems to benefit the robustness and longevity of the body’s basic building blocks. (This would seem to be much easier and faster than HBOT. I'm requesting this at my next stroke, my doctor won't know what hit her when I tell her how to treat me.)

My list of 31 things I was going to demand after my next stroke. I guess metformin isn't in there.

 The latest here:

Association of pre-stroke metformin use, stroke severity, and thrombolysis outcome

Laura P Westphal, Roni Widmer, Ulrike Held, Klaus Steigmiller, View ORCID ProfileChristian Hametner, Peter Ringleb, Sami Curtze, Nicolas Martinez-Majander, Marjaana Tiainen, Christian H Nolte, Jan F Scheitz, Hebun Erdur, Alexandros A Polymeris, Christopher Traenka, Ashraf Eskandari, Patrik Michel, View ORCID ProfileMirjam R Heldner, Marcel Arnold, View ORCID ProfileAndrea Zini, Laura Vandelli, Jonathan M Coutinho, Adrien E Groot, Visnja Padjen, Dejana R Jovanovic, Yannick Bejot, Céline Brenière, Guillaume Turc, Pierre Seners, Alessandro Pezzini, Mauro Magoni, Didier Leys, Sixtine Gilliot, Michael J Scherrer, Georg Kägi, Andreas R Luft, Henrik Gensicke, Paul Nederkoorn, Turgut Tatlisumak, Stefan T Engelter, Susanne Wegener

First published June 29, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009951

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Abstract

Objective: To evaluate whether pretreatment with metformin (MET) is associated with less stroke severity and better outcome after intravenous thrombolysis (IVT), we analyzed a cohort of 1919 stroke patients with type-2 diabetes in a multicenter exploratory analysis.

Methods: Data from patients with diabetes affected by ischemic stroke treated with IVT were collected within the European Thrombolysis in Ischemic Stroke Patients (TRISP) collaboration. We applied propensity score matching (PSM) to obtain balanced baseline characteristics of patients treated with and without MET.

Results: Of 1919 stroke patients with type-2 diabetes who underwent IVT, 757 (39%) had received MET before stroke (MET+), whereas 1162 (61%) had not (MET-). MET+ patients were younger with a male preponderance. Hypercholesterolemia and pretreatment with statins, antiplatelets or antihypertensives were more common in the MET+ group. After PSM, the two groups were well balanced with respect to demographic and clinical aspects. Stroke severity on admission (NIHSS 10.0 ± 6.7 vs. 11.3 ± 6.5), 3-months degree of independence on modified Rankin Scale (mRS): 2 [IQR 1.0, 4.0] vs. 3 [IQR 1.0, 4.0] as well as mortality (12.5% vs. 18%) were significantly lower in the MET+ group. The frequency of symptomatic intracerebral hemorrhages did not differ between groups. HbA1c levels were well balanced between both groups.

Conclusions: Stroke patients with diabetes on treatment with MET receiving IVT had less severe strokes on admission and a better functional outcome at 3 months. This suggests a protective effect of MET resulting in less severe strokes as well as beneficial thrombolysis outcome.

• Received April 19, 2019.
• Accepted in final form January 6, 2020.

• © 2020 American Academy of Neurology