Fasting Hyperglycemia and Long-term Outcome in Patients with Acute Ischemic Stroke Treated with Mechanical Thrombectomy
| Autor: | Marcin Wnuk, Roman Pulyk, Paweł Brzegowy, Leszek Drabik, Agnieszka Slowik, Marcin Wiacek, Tadeusz Popiela, Dorota Wloch-Kopec, Halina Bartosik-Psujek, Jeremiasz M. Jagiella, Bartosz Lasocha, Rafał Kaczorowski |
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| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Time Factors Risk Assessment Brain Ischemia Disability Evaluation 03 medical and health sciences 0302 clinical medicine Risk Factors Modified Rankin Scale Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans In patient Risk factor Acute ischemic stroke Stroke Aged Retrospective Studies Thrombectomy Aged 80 and over business.industry Rehabilitation Fasting Middle Aged medicine.disease Mechanical thrombectomy Treatment Outcome Hyperglycemia Ischemic stroke Cardiology Female Surgery Poland Neurology (clinical) Cardiology and Cardiovascular Medicine business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 29:104774 |
| ISSN: | 1052-3057 |
| Popis: | Little is known about the prognostic role of fasting glucose after mechanical thrombectomy (MT).We investigated whether fasting glucose on the next day after MT was associated with long-term outcome in acute ischemic stroke patients according to diabetes.We retrospectively analyzed 181 consecutive patients with acute anterior circulation ischemic stroke who underwent MT in 2 comprehensive stroke centers in Poland. Glucose levels were evaluated on admission and on the next day after MT. Fasting hyperglycemia (FHG) was defined as the glucose level above 5.5 mmol/L. Unfavorable outcome was defined as modified Rankin scale (mRS) of 3-6 at day 90 from stroke onset.Patients with FHG had higher mRS at 3-month follow-up compared with those without FHG (3.71 ± 2.56 versus 1.87 ± 2.22, P.001). In the subgroup analyses, FHG was associated with poor neurological outcome in the group without diabetes (3.74 ± 2.52 versus 1.81 ± 3.74, P.001) but not with diabetes (3.64 ± 2.67 versus 2.30 ± 3.74, P= .11). Patients without diabetes who had FHG were older, had higher glucose on admission, higher prevalence of atrial fibrillation, cardioembolic stroke etiology and bleeding brain complications compared with the group with normal fasting glucose. After adjustment for potential confounders, fasting glucose (odds ratio [OR] 1.46; 95% CI 1.19-1.79, P.001), age (OR 1.06; 95% CI 1.02-1.10, P = .001), successful reperfusion (OR 0.09; 95% CI 0.04-0.22, P.001) and baseline NIHSS score (OR 1.18; 95% CI 1.08-1.29, P.001) were predictors of mRS 3-6 at 3-month follow-up in the whole group. In the subgroup without diabetes, fasting glucose (OR 1.57; 95% CI 1.17-2.11, P = .002), age (OR 1.05; 95% CI 1.01-1.08, P = .008), successful reperfusion (OR 0.11; 95% CI 0.04-0.30, P.001) and baseline NIHSS score (OR 1.14; 95% CI 1.04-1.26, P = .011) were independent predictors of unfavorable 3-month outcome.Fasting glucose on the next day after MT in patients with acute ischemic stroke is an independent risk factor for worse 3-month outcome. |
| Databáze: | OpenAIRE |
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