Associations of diabetes status and glucose measures with outcomes after endovascular therapy in patients with acute ischemic stroke: an analysis of the nationwide TREAT-AIS registry

Meng Tsang Hsieh, Cheng Yang Hsieh, Tzu Hsien Yang, Sheng Feng Sung, Yi Chen Hsieh, Chung Wei Lee, Chun Jen Lin, Yu Wei Chen, Kuan Hung Lin, Pi Shan Sung, Chih Wei Tang, Hai Jui Chu, Kun Chang Tsai, Chao Liang Chou, Ching Huang Lin, Cheng Yu Wei, Te Yuan Chen, Shang Yih Yan, Po Lin Chen, Chen Yu HsiaoLung Chan, Yen Chu Huang, Hon Man Liu, Sung Chun Tang, I. Hui Lee, Li Ming Lien, Hung Yi Chiou, Jiunn Tay Lee, Jiann Shing Jeng

研究成果: 雜誌貢獻文章同行評審

摘要

Background: Hyperglycemia affects the outcomes of endovascular therapy (EVT) for acute ischemic stroke (AIS). This study compares the predictive ability of diabetes status and glucose measures on EVT outcomes using nationwide registry data. Methods: The study included 1,097 AIS patients who underwent EVT from the Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke. The variables analyzed included diabetes status, admission glucose, glycated hemoglobin (HbA1c), admission glucose-to-HbA1c ratio (GAR), and outcomes such as 90-day poor functional outcome (modified Rankin Scale score ≥ 2) and symptomatic intracranial hemorrhage (SICH). Multivariable analyses investigated the independent effects of diabetes status and glucose measures on outcomes. A receiver operating characteristic (ROC) analysis was performed to compare their predictive abilities. Results: The multivariable analysis showed that individuals with known diabetes had a higher likelihood of poor functional outcomes (odds ratios [ORs] 2.10 to 2.58) and SICH (ORs 3.28 to 4.30) compared to those without diabetes. Higher quartiles of admission glucose and GAR were associated with poor functional outcomes and SICH. Higher quartiles of HbA1c were significantly associated with poor functional outcomes. However, patients in the second HbA1c quartile (5.6–5.8%) showed a non-significant tendency toward good functional outcomes compared to those in the lowest quartile (<5.6%). The ROC analysis indicated that diabetes status and admission glucose had higher predictive abilities for poor functional outcomes, while admission glucose and GAR were better predictors for SICH. Conclusion: In AIS patients undergoing EVT, diabetes status, admission glucose, and GAR were associated with 90-day poor functional outcomes and SICH. Admission glucose was likely the most suitable glucose measure for predicting outcomes after EVT.
原文英語
文章編號1351150
期刊Frontiers in Neurology
15
DOIs
出版狀態已發佈 - 2024

ASJC Scopus subject areas

  • 神經內科
  • 神經病學(臨床)

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