The silver effect of admission glucose level on excellent outcome in thrombolysed stroke patients

Journal of Neurology
Charlotte RossoYves Samson

Abstract

Higher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL's impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month modified Rankin score of 0-1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each OTT time quartile if the interaction was significant. AGL, baseline NIHSS, age, and OTT time quartiles were significant predictors. When added in the model, the AGL × OTT interaction was significant (OR: 0.96, 95% CI: 0.94-0.99, p: 0.0009). AGL was predictive only during the third OTT time quartile (181-224 min). During this period, the predicted rate of excellent outcome was 16% for AGL = 6.5 mmol/L and 8% for AGL = 8 mmol/L. The rate of excellent outcome was not decreased in hyperglycemic patients for OTT time ≤ 180 min (20 vs. 24.5% p: 0.37), but was decreased for OTT time > 180 min (9.6 vs. 26.7% p: 0.00001). Similar results...Continue Reading

References

Apr 5, 2003·Stroke; a Journal of Cerebral Circulation·José Alvarez-SabínManuel Quintana
Oct 9, 2004·Stroke; a Journal of Cerebral Circulation·José Alvarez-SabínMarta Rubiera
Nov 19, 2004·The New England Journal of Medicine·Andrei V AlexandrovUNKNOWN CLOTBUST Investigators
Nov 25, 2005·Stroke; a Journal of Cerebral Circulation·Rajesh GargParesh Dandona
Feb 15, 2007·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Marc RiboJose Alvarez-Sabin
Nov 7, 2009·Cerebrovascular Diseases·D A De SilvaUNKNOWN Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) Investigators
Jan 21, 2010·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Mark W ParsonsUNKNOWN Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) Investigators
Jun 5, 2010·Stroke; a Journal of Cerebral Circulation·Jeffrey L SaverUNKNOWN GWTG-Stroke Steering Committee and Investigators
Apr 2, 2011·AJNR. American Journal of Neuroradiology·C RossoY Samson
Feb 22, 2012·Stroke; a Journal of Cerebral Circulation·Katja PiironenYves Samson
Jun 16, 2012·Stroke; a Journal of Cerebral Circulation·Charlotte RossoYves Samson
May 25, 2013·Stroke; a Journal of Cerebral Circulation·Jean-Philippe DesillesMikael Mazighi
Jan 24, 2014·The Cochrane Database of Systematic Reviews·M Fernanda BellolioLatha Ganti
Feb 13, 2014·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·T ShimoyamaK Shibazaki
Apr 20, 2014·Stroke; a Journal of Cerebral Circulation·Nathaniel M Robbins, Raymond A Swanson
Jun 27, 2015·Stroke; a Journal of Cerebral Circulation·Michael D HillMarc Fisher
Sep 28, 2016·JAMA : the Journal of the American Medical Association·Jeffrey L SaverUNKNOWN HERMES Collaborators

❮ Previous
Next ❯

Citations

Jul 17, 2021·Neural Regeneration Research·Federica FerrariRoberto Federico Villa
Apr 6, 2020·Clinical Neurology and Neurosurgery·Laurent SuissaEmmanuelle Robinet-Borgomano

❮ Previous
Next ❯

Software Mentioned

INSULINFARCT

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

Journal of Neurosciences in Rural Practice
Pornpatr Dharmasaroja, Sombat Muengtaweepongsa
Stroke; a Journal of Cerebral Circulation
Mayank GoyalPenumbra Pivotal Stroke Trial Investigators, Calgary Stroke Program, and the Seaman MR Research Center
© 2022 Meta ULC. All rights reserved