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.
Journal
Frontiers in neurology
Journal Volume
15
ISSN
1664-2295
Date Issued
2024
Author(s)
Hsieh, Meng-Tsang
Hsieh, Cheng-Yang
Yang, Tzu-Hsien
Sung, Sheng-Feng
Hsieh, Yi-Chen
Lin, Chun-Jen
Chen, Yu-Wei
Lin, Kuan-Hung
Sung, Pi-Shan
Tang, Chih-Wei
Chu, Hai-Jui
Tsai, Kun-Chang
Chou, Chao-Liang
Lin, Ching-Huang
Wei, Cheng-Yu
Chen, Te-Yuan
Yan, Shang-Yih
Chen, Po-Lin
Hsiao, Chen-Yu
Chan, Lung
Huang, Yen-Chu
Tang, Sung-Chun
Lee, I-Hui
Lien, Li-Ming
Chiou, Hung-Yi
Lee, Jiunn-Tay
Jeng, Jiann-Shing
DOI
10.3389/fneur.2024.1351150
Abstract
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.
Subjects
acute ischemic stroke
diabetes
endovascular therapy
outcomes
plasma glucose
SDGs
Publisher
Frontiers Media SA
Description
Article number 1351150
Type
journal article