Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy
Stress hyperglycemia may impair outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). The glucose-to-glycated hemoglobin ratio (GAR) was used to measure stress hyperglycemia. Data from our database of consecutive patients admitted to the Udine University Hosp...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.725002/full |
| _version_ | 1819067252855537664 |
|---|---|
| author | Giovanni Merlino Giovanni Merlino Sara Pez Sara Pez Gian Luigi Gigli Gian Luigi Gigli Massimo Sponza Simone Lorenzut Andrea Surcinelli Andrea Surcinelli Carmelo Smeralda Carmelo Smeralda Mariarosaria Valente Mariarosaria Valente |
| author_facet | Giovanni Merlino Giovanni Merlino Sara Pez Sara Pez Gian Luigi Gigli Gian Luigi Gigli Massimo Sponza Simone Lorenzut Andrea Surcinelli Andrea Surcinelli Carmelo Smeralda Carmelo Smeralda Mariarosaria Valente Mariarosaria Valente |
| author_sort | Giovanni Merlino |
| collection | DOAJ |
| description | Stress hyperglycemia may impair outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). The glucose-to-glycated hemoglobin ratio (GAR) was used to measure stress hyperglycemia. Data from our database of consecutive patients admitted to the Udine University Hospital with AIS who were treated with MT between January 2015 and December 2020 were retrospectively analyzed. We included 204 patients in the study and stratified them into four groups according to the quartiles of GAR (Q1–Q4). The higher the GAR index, the more severe the stress hyperglycemia was considered. Patients with more severe stress hyperglycemia showed a higher prevalence of 3-month poor outcome (Q1, 53.1%; Q2, 40.4%; Q3, 63.5%; Q4, 82.4%; p = 0.001), 3-month mortality (Q1, 14.3%; Q2, 11.5%; Q3, 15.4%; Q4, 31.4%; p = 0.001), and symptomatic intracranial hemorrhage (Q1, 2%; Q2, 7.7%; Q3, 7.7%; Q4, 25.4%; p = 0.001). After controlling for several confounders, severe stress hyperglycemia remained a significant predictor of 3-month poor outcome (OR 4.52, 95% CI 1.4–14.62, p = 0.012), 3-month mortality (OR 3.55, 95% CI 1.02–12.29, p = 0.046), and symptomatic intracranial hemorrhage (OR 6.89, 95% CI 1.87–25.36, p = 0.004). In summary, stress hyperglycemia, as measured by the GAR index, is associated with a detrimental effect in patients with AIS undergoing MT. |
| first_indexed | 2024-12-21T16:15:18Z |
| format | Article |
| id | doaj.art-4a62b5e3a4094535b1c93e193da48ea3 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-21T16:15:18Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-4a62b5e3a4094535b1c93e193da48ea32022-12-21T18:57:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-09-011210.3389/fneur.2021.725002725002Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical ThrombectomyGiovanni Merlino0Giovanni Merlino1Sara Pez2Sara Pez3Gian Luigi Gigli4Gian Luigi Gigli5Massimo Sponza6Simone Lorenzut7Andrea Surcinelli8Andrea Surcinelli9Carmelo Smeralda10Carmelo Smeralda11Mariarosaria Valente12Mariarosaria Valente13Stroke Unit, Department of Neuroscience, Udine University Hospital, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyDipartimento di Area Medica (DAME), University of Udine, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyDipartimento di Area Medica (DAME), University of Udine, Udine, ItalyDivision of Vascular and Interventional Radiology, Udine University Hospital, Udine, ItalyStroke Unit, Department of Neuroscience, Udine University Hospital, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyDipartimento di Area Medica (DAME), University of Udine, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyDipartimento di Area Medica (DAME), University of Udine, Udine, ItalyClinical Neurology, Udine University Hospital, Udine, ItalyDipartimento di Area Medica (DAME), University of Udine, Udine, ItalyStress hyperglycemia may impair outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). The glucose-to-glycated hemoglobin ratio (GAR) was used to measure stress hyperglycemia. Data from our database of consecutive patients admitted to the Udine University Hospital with AIS who were treated with MT between January 2015 and December 2020 were retrospectively analyzed. We included 204 patients in the study and stratified them into four groups according to the quartiles of GAR (Q1–Q4). The higher the GAR index, the more severe the stress hyperglycemia was considered. Patients with more severe stress hyperglycemia showed a higher prevalence of 3-month poor outcome (Q1, 53.1%; Q2, 40.4%; Q3, 63.5%; Q4, 82.4%; p = 0.001), 3-month mortality (Q1, 14.3%; Q2, 11.5%; Q3, 15.4%; Q4, 31.4%; p = 0.001), and symptomatic intracranial hemorrhage (Q1, 2%; Q2, 7.7%; Q3, 7.7%; Q4, 25.4%; p = 0.001). After controlling for several confounders, severe stress hyperglycemia remained a significant predictor of 3-month poor outcome (OR 4.52, 95% CI 1.4–14.62, p = 0.012), 3-month mortality (OR 3.55, 95% CI 1.02–12.29, p = 0.046), and symptomatic intracranial hemorrhage (OR 6.89, 95% CI 1.87–25.36, p = 0.004). In summary, stress hyperglycemia, as measured by the GAR index, is associated with a detrimental effect in patients with AIS undergoing MT.https://www.frontiersin.org/articles/10.3389/fneur.2021.725002/fullstress hyperglycemiaGAR indexacute ischemic strokeoutcomemechanical thrombectomy |
| spellingShingle | Giovanni Merlino Giovanni Merlino Sara Pez Sara Pez Gian Luigi Gigli Gian Luigi Gigli Massimo Sponza Simone Lorenzut Andrea Surcinelli Andrea Surcinelli Carmelo Smeralda Carmelo Smeralda Mariarosaria Valente Mariarosaria Valente Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy Frontiers in Neurology stress hyperglycemia GAR index acute ischemic stroke outcome mechanical thrombectomy |
| title | Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy |
| title_full | Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy |
| title_fullStr | Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy |
| title_full_unstemmed | Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy |
| title_short | Stress Hyperglycemia in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion Undergoing Mechanical Thrombectomy |
| title_sort | stress hyperglycemia in patients with acute ischemic stroke due to large vessel occlusion undergoing mechanical thrombectomy |
| topic | stress hyperglycemia GAR index acute ischemic stroke outcome mechanical thrombectomy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.725002/full |
| work_keys_str_mv | AT giovannimerlino stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT giovannimerlino stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT sarapez stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT sarapez stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT gianluigigigli stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT gianluigigigli stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT massimosponza stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT simonelorenzut stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT andreasurcinelli stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT andreasurcinelli stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT carmelosmeralda stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT carmelosmeralda stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT mariarosariavalente stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy AT mariarosariavalente stresshyperglycemiainpatientswithacuteischemicstrokeduetolargevesselocclusionundergoingmechanicalthrombectomy |