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06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Glycemic variability after mechanical thrombectomy for anterior circulation acute ischemic stroke
A Cabral1, A Carvalho1, P Barros1
1Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Revista De Neurologia
|June 27, 2024
Summary
High glycemic variability (GV) after mechanical thrombectomy for acute ischemic stroke (AIS) is linked to increased mortality. This study suggests managing GV may improve outcomes for stroke patients.
Area of Science:
- Neuroscience
- Endocrinology
- Cardiovascular Medicine
Background:
- Mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO) has high morbidity.
- Stress hyperglycemia worsens outcomes in acute ischemic stroke (AIS), but aggressive glucose control offers no benefit.
- Glycemic variability (GV) is a potential, unaddressed factor impacting AIS patient prognosis.
Purpose of the Study:
- To investigate the impact of GV on patient outcomes following MT for anterior circulation LVO.
- To determine if GV is an independent predictor of mortality and functional outcome in AIS patients treated with MT.
Main Methods:
- Single-center retrospective study including 657 patients undergoing MT for anterior circulation LVO.
- Calculation of GV using standard deviation (SD) and coefficient of variation from blood glucose measurements within 24 hours post-thrombectomy.
- Univariate and multivariate analyses to identify predictors of poor functional outcome (modified Rankin Scale score 3-6) and 3-month mortality.
Main Results:
- Patients with poor functional outcome (42.5%) and mortality (14.8%) exhibited significantly higher GV (SD).
- Higher GV (SD) was independently associated with increased 3-month mortality (adjusted odds ratio: 1.020; 95% CI: 1.001-1.040).
- GV (SD) was not significantly associated with poor functional outcome (adjusted odds ratio: 1.007; 95% CI: 0.990-1.025).
Conclusions:
- Elevated glycemic variability post-MT for anterior circulation AIS is an independent risk factor for 3-month mortality.
- The findings suggest a potential therapeutic target for improving outcomes in this patient population.
- Future clinical trials are warranted to assess the efficacy of interventions aimed at reducing GV in AIS patients.
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