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
Hauptverfasser: 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
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container_end_page 2148
container_issue 9
container_start_page 2140
container_title Diabetes care
container_volume 44
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.
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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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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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