Higher blood glucose is associated with the severity of hemorrhagic transformation after endovascular therapy for stroke.
J Stroke Cerebrovasc Dis
; 33(8): 107823, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38880367
ABSTRACT
OBJECTIVES:
Hyperglycemia is associated with poor outcome in large vessel occlusion (LVO) stroke, with mechanism for this effect unknown. MATERIALS ANDMETHODS:
We used our prospective, multicenter, observational study, Blood Pressure After Endovascular Stroke Therapy (BEST), of anterior circulation LVO stroke undergoing endovascular therapy (EVT) from 11/2017-7/2018 to determine association between increasing blood glucose (BG) and intracerebral hemorrhage (ICH). Our primary outcome was degree of ICH, classified as none, asymptomatic ICH, or symptomatic ICH (≥4-point increase in National Institutes of Health Stroke Scale [NIHSS] at 24 h with any hemorrhage on imaging). Secondary outcomes included 24 h NIHSS, early neurologic recovery (ENR, NIHSS 0-1 or NIHSS reduction by ≥8 within 24 h), and 90-day modified Rankin Scale (mRS) using univariate and multivariable regression.RESULTS:
Of 485 enrolled patients, increasing BG was associated with increasing severity of ICH (adjusted OR, aOR 1.06, 95 % CI 1.02-1.1, p < 0.001), higher 24 h NIHSS (aOR 1.22, 95 % CI 1.11-1.34, p < 0.001), ENR (aOR 0.90, 95 % CI 0.82-1.00, p < 0.002), and 90-day mRS (aOR 1.06, 95 % CI 1.03-1.09, p < 0.001) when adjusted for age, presenting NIHSS, ASPECTS, 24-hour peak systolic blood pressure, time from last known well, and successful recanalization.CONCLUSIONS:
In the BEST study, increasing BG was associated with greater odds of increasing ICH severity. Further study is warranted to determine whether treatment of will decrease ICH severity following EVT.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Severity of Illness Index
/
Blood Glucose
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Biomarkers
/
Cerebral Hemorrhage
/
Disability Evaluation
/
Endovascular Procedures
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Stroke Cerebrovasc Dis
/
J. stroke cerebrovasc. dis
/
Journal of stroke and cerebrovascular diseases
Journal subject:
ANGIOLOGIA
/
CEREBRO
Year:
2024
Document type:
Article
Country of publication: