Association between glucose parameters and outcome measures in acute ischemic stroke with intravenous thrombolytic treatment

doi:10.3969/j.issn.1006-7795.2017.01.011

Abstract

Abstract: Objective To investigate the association between glucose parameters and outcome measures in acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT). Methods Two hundred and two eligible cases were enrolled in the cohort study. Blood glucose (BG), fasting BG and glycosylated hemoglobin A1c (HbA1c) determined on admission were taken as continuous variables, therapeutic outcome measures[e.g., modified Rankin Scale (mRS)≤2 at discharge, early neurological improvement (ENI) or deterioration (END), and recanalization status] and safety outcome measures[symptomatic intracranial hemorrhage (SICH) and all intracranial hemorrhage (ICH)] were taken as endpoint indicators. Results Of the recruited cases, the median age was 61 years, 25.2% female, median National Institute of Health Stoke Scale (NIHSS) 9 scores and onset to needle (OTN) time 230 min. The median fasting BGs were much lower in subgroups with favorable outcome (mRS≤2) or recanalization than those in the related reference subgroups, while the comparisons according to ICH and SICH didn't reach significance. Significantly higher admission BG was only found in the comparison according to SICH and the HbA1c levels were similar in all comparisons. Adjusted for age, sex, OTN and baseline NIHSS, admission BG[odds ratio (OR), 1.24; 95% confidence interval (CI):1.03-1.50] was the only independent predictor of SICH, while fasting BG was negatively associated with all therapeutic outcome measures, with an OR of 0.72 (0.58-0.90) for mRS≤2 at discharge, an OR of 0.69 (0.55-0.87) for ENI, and an OR of 0.80 (0.66-0.98) for recanalization. Elevated fasting BG was only significantly associated with Non-SICH related END (OR:1.42, 95%CI:1.04-1.95) after adjustment for explanatory variables.Conclusion Acute glucose parameters could be independent predictors of outcomes in AIS after IVT and elevated fasting BG negatively affected the functional outcome probably through the mechanism of an impaired response of IVT.

Key words: blood glucose, ischemic stroke, alteplase, intravenous thrombolysis, outcome, safety

CLC Number:

R743.3

Huang Qiang, Ma Qingfeng, Song Haiqing, Wu Jian. Association between glucose parameters and outcome measures in acute ischemic stroke with intravenous thrombolytic treatment[J]. Journal of Capital Medical University, 2017, 38(1): 53-58.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2017.01.011

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2017/V38/I1/53

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