Admission hyperglycemia (≥144 mg/dL) was associated with lower 3-month functional independence in non-diabetic (53.3% vs 57.9%, P<0.001) and diabetic (48.2% vs 52.5%, P<0.001) AIS patients.
Observational (n=18,890)
Yes
Does admission hyperglycemia worsen outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis?
Admission hyperglycemia is associated with worse 3-month functional outcomes and higher mortality in acute ischemic stroke patients treated with IV thrombolysis, regardless of prior diabetes history.
Absolute Event Rate: 53.3% vs 57.9%
p-value: p=<0.001
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.
Tsivgoulis et al. (Wed,) conducted a observational in Acute ischemic stroke (n=18,890). Admission hyperglycemia (≥144 mg/dL) vs. Without admission hyperglycemia was evaluated on 3-month functional independence (mRS 0-2) in non-diabetic patients (p=<0.001). Admission hyperglycemia (≥144 mg/dL) was associated with lower 3-month functional independence in non-diabetic (53.3% vs 57.9%, P<0.001) and diabetic (48.2% vs 52.5%, P<0.001) AIS patients.