Association of Baseline Hyperglycemia With Outcomes of Patients With and Without Diabetes With Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Propensity Score-Matched Analysis From the SITS-ISTR Registry

被引:58
|
作者
Tsivgoulis, Georgios [1 ,2 ]
Katsanos, Aristeidis H. [1 ,3 ]
Mavridis, Dimitris [4 ,5 ]
Lambadiari, Vaia [6 ,7 ]
Roffe, Christine [8 ,9 ]
Macleod, Mary Joan [10 ]
Sevcik, Petr [11 ]
Cappellari, Manuel [12 ]
Nevsimalova, Miroslava [13 ]
Toni, Danilo [14 ]
Ahmed, Niaz [15 ,16 ]
机构
[1] Natl & Kapodistrian Univ Athens, Sch Med, Attikon Univ Hosp, Dept Neurol 2, Athens, Greece
[2] Univ Tennessee, Hlth Sci Ctr, Dept Neurol, Memphis, TN USA
[3] Ruhr Univ, St Josef Hosp, Dept Neurol, Bochum, Germany
[4] Univ Ioannina, Dept Primary Educ, Ioannina, Greece
[5] Univ Paris 05, Fac Med, Paris, France
[6] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Internal Med 2, Res Unit, Athens, Greece
[7] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Internal Med 2, Diabet Ctr, Athens, Greece
[8] Univ Hosp North Midlands, Stoke On Trent, Staffs, England
[9] Keele Univ, Keele, Staffs, England
[10] Univ Aberdeen, Div Appl Med, Foresterhill, Scotland
[11] Charles Univ Prague, Fac Med Pilsen, Dept Neurol, Plzen, Czech Republic
[12] Azienda Osped Univ Integrata Verona, Stroke Unit, Verona, Italy
[13] Hosp Ceske Budejovice, Dept Neurol, Statutory City, Czech Republic
[14] Univ Roma La Sapienza, Dept Human Neurosci, Neurovasc Unit, Policlin Umberto 1, Rome, Italy
[15] Karolinska Univ Hosp Solna, Dept Neurol, Stockholm, Sweden
[16] Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden
关键词
SYMPTOMATIC INTRACRANIAL HEMORRHAGE; ADMISSION HYPERGLYCEMIA; SAFE IMPLEMENTATION; POSTSTROKE HYPERGLYCEMIA; OXIDATIVE STRESS; GLUCOSE; PREDICTORS; ACTIVATION; MANAGEMENT; ALTEPLASE;
D O I
10.2337/db19-0440
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Available data from observational studies on the association of admission hyperglycemia (aHG) with outcomes of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) are contradictory, especially when stratified by diabetes mellitus (DM) history. We assessed the association of aHG (>= 144 mg/dL) with outcomes stratified by DM history using propensity score-matched (PSM) data from the SITS-ISTR. The primary safety outcome was symptomatic intracranial hemorrhage (SICH); 3-month functional independence (FI) (modified Rankin Scale [mRS] scores 0-2) represented the primary efficacy outcome. Patients with and without aHG did not differ in baseline characteristics both in the non-DM (n = 12,318) and DM (n = 6,572) PSM subgroups. In the non-DM group, patients with aHG had lower 3-month FI rates (53.3% vs. 57.9%, P < 0.001), higher 3-month mortality rates (19.2% vs. 16.0%, P < 0.001), and similar symptomatic intracerebral hemorrhage (SICH) rates (1.7% vs. 1.8%, P = 0.563) compared with patients without aHG. Similarly, in the DM group, patients with aHG had lower rates of 3-month favorable functional outcome (mRS scores 0-1, 34.1% vs. 39.3%, P < 0.001) and FI (48.2% vs. 52.5%, P < 0.001), higher 3-month mortality rates (23.7% vs. 19.9%, P < 0.001), and similar SICH rates (2.2% vs. 2.7%, P = 0.224) compared with patients without aHG. In conclusion, aHG was associated with unfavorable 3-month clinical outcomes in patients with and without DM and AIS treated with IVT.
引用
收藏
页码:1861 / 1869
页数:9
相关论文
共 50 条
  • [21] Association of Elevated Blood Pressure Levels with Outcomes in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A Systematic Review and Meta-Analysis
    Malhotra, Konark
    Ahmed, Niaz
    Filippatou, Angeliki
    Katsanos, Aristeidis H.
    Goyal, Nitin
    Tsioufis, Konstantinos
    Manios, Efstathios
    Pikilidou, Maria
    Schellinger, Peter D.
    Alexandrov, Anne W.
    Alexandrov, Andrei V.
    Tsivgoulis, Georgios
    JOURNAL OF STROKE, 2019, 21 (01) : 78 - +
  • [22] Short- and long-term mortality after intravenous thrombolysis for acute ischemic stroke A propensity score-matched cohort with 5-year follow-up
    Heo, Nam Hun
    Lee, Man Ryul
    Yang, Ki Hwa
    Hong, Ock Ran
    Shin, Ji Hyeon
    Lee, Bo Yeon
    Lee, Ji Young
    Ahn, Jae Min
    Oh, Hyuk Jin
    Oh, Jae Sang
    MEDICINE, 2021, 100 (44)
  • [23] Statin Use and Outcomes of Patients With Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Systematic Review and Meta-Analysis
    Guo, Yu
    Guo, Xinmei
    Zhao, Kai
    Bao, Qiangji
    Yang, Jincai
    Yang, Mingfei
    FRONTIERS IN NEUROLOGY, 2021, 12
  • [24] Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry
    Tsivgoulis, G.
    Katsanos, A. H.
    Kadlecova, P.
    Czlonkowska, A.
    Kobayashi, A.
    Brozman, M.
    Svigelj, V.
    Csiba, L.
    Fekete, K.
    Korv, J.
    Demarin, V.
    Vilionskis, A.
    Jatuzis, D.
    Krespi, Y.
    Karapanayiotides, T.
    Giannopoulos, S.
    Mikulik, R.
    EUROPEAN JOURNAL OF NEUROLOGY, 2017, 24 (12) : 1493 - 1498
  • [25] COMPARISON OF EFFECTIVENESS AND SAFETY BETWEEN ANGIOPLASTY AND USUAL ENDOVASCULAR TREATMENT FOR PATIENTS WITH ANTERIOR CIRCULATION ACUTE ISCHEMIC STROKE: A PROPENSITY SCORE-MATCHED ANALYSIS
    Kim, E.
    Seo, J.
    INTERNATIONAL JOURNAL OF STROKE, 2016, 11 (SUPP 3) : 87 - 87
  • [26] Is Thrombocytopenia an In-Hospital Mortality Risk Factor among Patients with Acute Ischemic Stroke? A Propensity Score-Matched Analysis from the MIMIC-IV Database
    Wang, Yan-Ru
    Yang, Li-Yu
    Lee, Cho-Hao
    Chang, Shu-Hao
    Chen, Po-Huang
    Jhou, Hong-Jie
    JOURNAL OF CLINICAL MEDICINE, 2023, 12 (02)
  • [27] Comparison of Effectiveness and Safety between Angioplasty and Usual Endovascular Treatment for Patients with Anterior Circulation Acute Ischemic Stroke: A Propensity Score-Matched Analysis
    Kim, E. G.
    Seo, J. W.
    CEREBROVASCULAR DISEASES, 2016, 42 : 52 - 52
  • [28] Association of Antiplatelet Pretreatment With Outcomes in Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis: A Systematic Review and Meta-analysis of Randomized Clinical Trials
    Tsivgoulis, Georgios
    Katsanos, Aristeidis H.
    Zand, Ramin
    Sharma, Vijay K.
    Kohrmann, Martin
    Giannopoulos, Sotirios
    Dardiotis, Efthymios
    Alexandrov, Anne W.
    Schellinger, Peter D.
    Alexandrov, Andrei V.
    STROKE, 2017, 48
  • [29] Admission Random Blood Glucose, Fasting Blood Glucose, Stress Hyperglycemia Ratio, and Functional Outcomes in Patients With Acute Ischemic Stroke Treated With Intravenous Thrombolysis
    Chen, Guangyong
    Ren, Junli
    Huang, Honghao
    Shen, Jiamin
    Yang, Chenguang
    Hu, Jingyu
    Pan, Wenjing
    Sun, Fangyue
    Zhou, Xinbo
    Zeng, Tian
    Li, Shengqi
    Yang, Dehao
    Weng, Yiyun
    FRONTIERS IN AGING NEUROSCIENCE, 2022, 14
  • [30] Association of serum magnesium levels with acute ischaemic stroke in patients with type 2 diabetes mellitus: a propensity score-matched case-control study
    Ibrahim, Anisha
    Legha, R.
    Ravi, Renju
    Raj, Jeffrey Pradeep
    Pushparajan, Libby
    BMJ OPEN, 2023, 13 (10):