Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy
To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT). From the Clinical Research Center for Stroke-Korea registry, we included patients with emergent larg...
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Veröffentlicht in: | Diabetes care 2021-09, Vol.44 (9), p.2140-2148 |
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creator | Chang, Jun Young Kim, Wook-Joo Kwon, Ji Hyun Kim, Beom Joon Kim, Joon-Tae Lee, Jun Cha, Jae Kwan Kim, Dae-Hyun Cho, Yong-Jin Hong, Keun-Sik Lee, Soo Joo Park, Jong-Moo Lee, Byung-Chul Oh, Mi Sun Lee, Sang-Hwa Kim, Chulho Kim, Dong-Eog Lee, Kyung Bok Park, Tae Hwan Choi, Jay Chol Shin, Dong-Ick Sohn, Sung-Il Hong, Jeong-Ho Lee, Ji Sung Bae, Hee-Joon Han, Moon-Ku |
description | To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT).
From the Clinical Research Center for Stroke-Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA
level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed.
A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA
at admission (
= 0.02 according to HbA
quintiles,
= 0.003 according to an HbA
cutoff value of 7.0%) than in those with lower HbA
levels. Higher HbA
levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0-7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period.
Prestroke glucose control with a target HbA
of ≤7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period. |
doi_str_mv | 10.2337/dc21-0271 |
format | Article |
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From the Clinical Research Center for Stroke-Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA
level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed.
A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA
at admission (
= 0.02 according to HbA
quintiles,
= 0.003 according to an HbA
cutoff value of 7.0%) than in those with lower HbA
levels. Higher HbA
levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0-7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period.
Prestroke glucose control with a target HbA
of ≤7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc21-0271</identifier><identifier>PMID: 34215632</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Blood Glucose ; Brain Ischemia ; Cardiovascular and Metabolic Risk ; Clinical outcomes ; Diabetes ; Diabetes Mellitus ; Disease management ; Glucose ; Humans ; Intravenous administration ; Occlusion ; Patients ; Retrospective Studies ; Stroke ; Stroke - therapy ; Thrombectomy ; Thrombolysis ; Treatment Outcome</subject><ispartof>Diabetes care, 2021-09, Vol.44 (9), p.2140-2148</ispartof><rights>2021 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Sep 1, 2021</rights><rights>2021 by the American Diabetes Association 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-53b25c178afea5df440fa80b711c2f6bf2ed6bdeace6f3ac16684fef0379e5823</citedby><cites>FETCH-LOGICAL-c403t-53b25c178afea5df440fa80b711c2f6bf2ed6bdeace6f3ac16684fef0379e5823</cites><orcidid>0000-0003-0166-387X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34215632$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Jun Young</creatorcontrib><creatorcontrib>Kim, Wook-Joo</creatorcontrib><creatorcontrib>Kwon, Ji Hyun</creatorcontrib><creatorcontrib>Kim, Beom Joon</creatorcontrib><creatorcontrib>Kim, Joon-Tae</creatorcontrib><creatorcontrib>Lee, Jun</creatorcontrib><creatorcontrib>Cha, Jae Kwan</creatorcontrib><creatorcontrib>Kim, Dae-Hyun</creatorcontrib><creatorcontrib>Cho, Yong-Jin</creatorcontrib><creatorcontrib>Hong, Keun-Sik</creatorcontrib><creatorcontrib>Lee, Soo Joo</creatorcontrib><creatorcontrib>Park, Jong-Moo</creatorcontrib><creatorcontrib>Lee, Byung-Chul</creatorcontrib><creatorcontrib>Oh, Mi Sun</creatorcontrib><creatorcontrib>Lee, Sang-Hwa</creatorcontrib><creatorcontrib>Kim, Chulho</creatorcontrib><creatorcontrib>Kim, Dong-Eog</creatorcontrib><creatorcontrib>Lee, Kyung Bok</creatorcontrib><creatorcontrib>Park, Tae Hwan</creatorcontrib><creatorcontrib>Choi, Jay Chol</creatorcontrib><creatorcontrib>Shin, Dong-Ick</creatorcontrib><creatorcontrib>Sohn, Sung-Il</creatorcontrib><creatorcontrib>Hong, Jeong-Ho</creatorcontrib><creatorcontrib>Lee, Ji Sung</creatorcontrib><creatorcontrib>Bae, Hee-Joon</creatorcontrib><creatorcontrib>Han, Moon-Ku</creatorcontrib><title>Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT).
From the Clinical Research Center for Stroke-Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA
level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed.
A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA
at admission (
= 0.02 according to HbA
quintiles,
= 0.003 according to an HbA
cutoff value of 7.0%) than in those with lower HbA
levels. Higher HbA
levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0-7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period.
Prestroke glucose control with a target HbA
of ≤7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period.</description><subject>Blood Glucose</subject><subject>Brain Ischemia</subject><subject>Cardiovascular and Metabolic Risk</subject><subject>Clinical outcomes</subject><subject>Diabetes</subject><subject>Diabetes Mellitus</subject><subject>Disease management</subject><subject>Glucose</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Occlusion</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Stroke</subject><subject>Stroke - therapy</subject><subject>Thrombectomy</subject><subject>Thrombolysis</subject><subject>Treatment Outcome</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdtqFTEUhoModlu98AUk4I1ejOY4hxths7W1sKEFq16GTGalO3Vm0uZQ6AP43mbYbbG9CiQfX9b6f4TeUvKJcd58HgyjFWENfYZWtOOyklK0z9GKUNFVsuvYAXoV4yUhRIi2fYkOuGBU1pyt0N-zADEF_wfw8ZiNj4A3fi4XI9bzgI_ybJLzsx7xaU7GT4DdjM90cjCniH-7tMNrkxPgrQ4XgH9BjFBYY8Yc3Q3gH3v34vrqdA8JIl7bBAGf74KfejDJT7ev0Qurxwhv7s5D9PPo2_nme7U9PT7ZrLeVEYSnSvKeSUObVlvQcrBCEKtb0jeUGmbr3jIY6n4AbaC2XBta162wYAlvOpAt44foy957lfsJBlOWCHpUV8FNOtwqr516_DK7nbrwN6ptBOmYLIIPd4Lgr3NJTk0uGhhHPYPPUbESvCCypstf75-glz6HkuRC1Z2ghJGmUB_3lAk-xgD2YRhK1FKuWspVS7mFfff_9A_kfZv8H2Tholw</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Chang, Jun Young</creator><creator>Kim, Wook-Joo</creator><creator>Kwon, Ji Hyun</creator><creator>Kim, Beom Joon</creator><creator>Kim, Joon-Tae</creator><creator>Lee, Jun</creator><creator>Cha, Jae Kwan</creator><creator>Kim, Dae-Hyun</creator><creator>Cho, Yong-Jin</creator><creator>Hong, Keun-Sik</creator><creator>Lee, Soo Joo</creator><creator>Park, Jong-Moo</creator><creator>Lee, Byung-Chul</creator><creator>Oh, Mi Sun</creator><creator>Lee, Sang-Hwa</creator><creator>Kim, Chulho</creator><creator>Kim, Dong-Eog</creator><creator>Lee, Kyung Bok</creator><creator>Park, Tae Hwan</creator><creator>Choi, Jay Chol</creator><creator>Shin, Dong-Ick</creator><creator>Sohn, Sung-Il</creator><creator>Hong, Jeong-Ho</creator><creator>Lee, Ji Sung</creator><creator>Bae, Hee-Joon</creator><creator>Han, Moon-Ku</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0166-387X</orcidid></search><sort><creationdate>20210901</creationdate><title>Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy</title><author>Chang, Jun Young ; Kim, Wook-Joo ; Kwon, Ji Hyun ; Kim, Beom Joon ; Kim, Joon-Tae ; Lee, Jun ; Cha, Jae Kwan ; Kim, Dae-Hyun ; Cho, Yong-Jin ; Hong, Keun-Sik ; Lee, Soo Joo ; Park, Jong-Moo ; Lee, Byung-Chul ; Oh, Mi Sun ; Lee, Sang-Hwa ; Kim, Chulho ; Kim, Dong-Eog ; Lee, Kyung Bok ; Park, Tae Hwan ; Choi, Jay Chol ; Shin, Dong-Ick ; Sohn, Sung-Il ; Hong, Jeong-Ho ; Lee, Ji Sung ; Bae, Hee-Joon ; Han, Moon-Ku</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-53b25c178afea5df440fa80b711c2f6bf2ed6bdeace6f3ac16684fef0379e5823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood Glucose</topic><topic>Brain Ischemia</topic><topic>Cardiovascular and Metabolic Risk</topic><topic>Clinical outcomes</topic><topic>Diabetes</topic><topic>Diabetes Mellitus</topic><topic>Disease management</topic><topic>Glucose</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Occlusion</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Stroke</topic><topic>Stroke - therapy</topic><topic>Thrombectomy</topic><topic>Thrombolysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Jun Young</creatorcontrib><creatorcontrib>Kim, Wook-Joo</creatorcontrib><creatorcontrib>Kwon, Ji Hyun</creatorcontrib><creatorcontrib>Kim, Beom Joon</creatorcontrib><creatorcontrib>Kim, Joon-Tae</creatorcontrib><creatorcontrib>Lee, Jun</creatorcontrib><creatorcontrib>Cha, Jae Kwan</creatorcontrib><creatorcontrib>Kim, Dae-Hyun</creatorcontrib><creatorcontrib>Cho, Yong-Jin</creatorcontrib><creatorcontrib>Hong, Keun-Sik</creatorcontrib><creatorcontrib>Lee, Soo Joo</creatorcontrib><creatorcontrib>Park, Jong-Moo</creatorcontrib><creatorcontrib>Lee, Byung-Chul</creatorcontrib><creatorcontrib>Oh, Mi Sun</creatorcontrib><creatorcontrib>Lee, Sang-Hwa</creatorcontrib><creatorcontrib>Kim, Chulho</creatorcontrib><creatorcontrib>Kim, Dong-Eog</creatorcontrib><creatorcontrib>Lee, Kyung Bok</creatorcontrib><creatorcontrib>Park, Tae Hwan</creatorcontrib><creatorcontrib>Choi, Jay Chol</creatorcontrib><creatorcontrib>Shin, Dong-Ick</creatorcontrib><creatorcontrib>Sohn, Sung-Il</creatorcontrib><creatorcontrib>Hong, Jeong-Ho</creatorcontrib><creatorcontrib>Lee, Ji Sung</creatorcontrib><creatorcontrib>Bae, Hee-Joon</creatorcontrib><creatorcontrib>Han, Moon-Ku</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Jun Young</au><au>Kim, Wook-Joo</au><au>Kwon, Ji Hyun</au><au>Kim, Beom Joon</au><au>Kim, Joon-Tae</au><au>Lee, Jun</au><au>Cha, Jae Kwan</au><au>Kim, Dae-Hyun</au><au>Cho, Yong-Jin</au><au>Hong, Keun-Sik</au><au>Lee, Soo Joo</au><au>Park, Jong-Moo</au><au>Lee, Byung-Chul</au><au>Oh, Mi Sun</au><au>Lee, Sang-Hwa</au><au>Kim, Chulho</au><au>Kim, Dong-Eog</au><au>Lee, Kyung Bok</au><au>Park, Tae Hwan</au><au>Choi, Jay Chol</au><au>Shin, Dong-Ick</au><au>Sohn, Sung-Il</au><au>Hong, Jeong-Ho</au><au>Lee, Ji Sung</au><au>Bae, Hee-Joon</au><au>Han, Moon-Ku</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>44</volume><issue>9</issue><spage>2140</spage><epage>2148</epage><pages>2140-2148</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT).
From the Clinical Research Center for Stroke-Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA
level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed.
A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA
at admission (
= 0.02 according to HbA
quintiles,
= 0.003 according to an HbA
cutoff value of 7.0%) than in those with lower HbA
levels. Higher HbA
levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0-7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period.
Prestroke glucose control with a target HbA
of ≤7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>34215632</pmid><doi>10.2337/dc21-0271</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-0166-387X</orcidid><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
subjects | Blood Glucose Brain Ischemia Cardiovascular and Metabolic Risk Clinical outcomes Diabetes Diabetes Mellitus Disease management Glucose Humans Intravenous administration Occlusion Patients Retrospective Studies Stroke Stroke - therapy Thrombectomy Thrombolysis Treatment Outcome |
title | Prestroke Glucose Control and Functional Outcome in Patients With Acute Large Vessel Occlusive Stroke and Diabetes After Thrombectomy |
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