Influence of prestroke glycemic status on outcomes by age in patients with acute ischemic stroke and diabetes mellitus

被引：1

作者：

Kim, Joon-Tae ^{[1
]}

Lee, Ji Sung ^{[2
]}

Kim, Hyunsoo ^{[1
]}

Kim, Beom Joon ^{[3
]}

Kang, Jihoon ^{[3
]}

Lee, Keon-Joo ^{[4
]}

Park, Jong-Moo ^{[5
]}

Kang, Kyusik ^{[6
]}

Lee, Soo Joo ^{[7
]}

Kim, Jae Guk ^{[7
]}

Cha, Jae-Kwan ^{[8
]}

Kim, Dae-Hyun ^{[8
]}

Park, Tai Hwan ^{[9
]}

Lee, Kyungbok ^{[10
]}

Lee, Jun ^{[11
]}

Hong, Keun-Sik ^{[12
]}

Cho, Yong-Jin ^{[12
]}

Park, Hong-Kyun ^{[12
]}

Lee, Byung-Chul ^{[13
]}

Yu, Kyung-Ho ^{[13
]}

Oh, Mi Sun ^{[13
]}

Kim, Dong-Eog ^{[14
]}

Choi, Jay Chol ^{[15
]}

Kwon, Jee-Hyun ^{[16
]}

Kim, Wook-Joo ^{[16
]}

Shin, Dong-Ick ^{[17
]}

Yum, Kyu Sun ^{[17
]}

Sohn, Sung Il ^{[18
]}

Hong, Jeong-Ho ^{[18
]}

Lee, Sang-Hwa ^{[19
]}

Kim, Chulho ^{[19
]}

Park, Man-Seok ^{[1
]}

Ryu, Wi-Sun ^{[20
]}

Park, Kwang-Yeol ^{[21
]}

Lee, Juneyoung ^{[22
]}

Saver, Jeffrey L. ^{[23
,24
]}

Bae, Hee-Joon ^{[3
]}

机构：

[1] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Med Sch, Dept Neurol, 42 Jebongro, Gwangju 61469, South Korea

[2] Univ Ulsan, Coll Med, Asan Med Ctr, Asan Inst Life Sci,Clin Res Ctr, Seoul, South Korea

[3] Seoul Natl Univ, Coll Med, Dept Neurol, Bundang Hosp, Seongnam, South Korea

[4] Korea Univ, Guro Hosp, Dept Neurol, Seoul, South Korea

[5] Eulji Univ, Sch Med, Uijeongbu Eulji Med Ctr, Dept Neurol, Uijeongbu Si, South Korea

[6] Eulji Univ, Sch Med, Nowon Eulji Med Ctr, Dept Neurol, Seoul, South Korea

[7] Eulji Univ, Daejeon Eulji Med Ctr, Dept Neurol, Sch Med, Daejeon, South Korea

[8] Dong A Univ Hosp, Dept Neurol, Busan, South Korea

[9] Seoul Med Ctr, Dept Neurol, Seoul, South Korea

[10] Soonchunhyang Univ, Coll Med, Dept Nucl Med, Soonchunhyang Univ Hosp Seoul, Seoul, South Korea

[11] Yeungnam Univ Hosp, Dept Neurol, Daegu, South Korea

[12] Inje Univ, Ilsan Paik Hosp, Dept Neurol, Goyang, South Korea

[13] Hallym Univ, Sacred Heart Hosp, Dept Neurol, Anyang, South Korea

[14] Dongguk Univ, Ilsan Hosp, Dept Neurol, Goyang, South Korea

[15] Jeju Natl Univ, Jeju Natl Univ Hosp, Dept Neurol, Sch Med, Jeju, South Korea

[16] Univ Ulsan, Coll Med, Dept Neurol, Ulsan, South Korea

[17] Chungbuk Natl Univ Hosp, Dept Neurol, Cheongju, South Korea

[18] Keimyung Univ, Dongsan Med Ctr, Dept Neurol, Daegu, South Korea

[19] Hallym Univ, Chuncheon Sacred Heart Hosp, Chuncheon Si, Gangwon Do, South Korea

[20] JLK Inc, Artificial Intelligence Res Ctr, Seoul, South Korea

[21] Chung Ang Univ, Coll Med, Chung Ang Univ Hosp, Dept Neurol, Seoul, South Korea

[22] Korea Univ, Dept Biostat, Coll Med, Seoul, South Korea

[23] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA

[24] Univ Calif Los Angeles, Comprehens Stroke Ctr, David Geffen Sch Med, Los Angeles, CA USA

来源：

EUROPEAN JOURNAL OF NEUROLOGY | 2025年 / 32卷 / 01期

关键词：

acute ischemic stroke; age; diabetes; glycated hemoglobin (hbA1c); prestroke glycemic status; RISK-FACTOR; HYPERGLYCEMIA; HYPOGLYCEMIA; MULTICENTER; SUBTYPE;

D O I：

10.1111/ene.70004

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: This study aimed to explore the association between admission HbA1c and the risk of 1-year vascular outcomes stratified by age group in patients with acute ischemic stroke (AIS) and diabetes mellitus (DM). Methods: This study analyzed prospective multicenter data from patients with AIS and DM. Admission HbA1C were categorized as:<= 6.0%, 6.1%-7.0%, 7.1%-8.0%, and >8.0%. Age was analyzed in categories:<= 55 years, 56-65 years, 66-75 years, 76-85 years, and >85 years. The primary outcome was 1-year composite of stroke, MI, and all-cause mortality. The modifying effect of age on the relationships between HbA1c and 1-year primary outcome was explored by Cox proportional hazards model. Results: A total of 16,077 patients (age 69.0 +/- 12.4 years; 59.4% males) were analyzed in this study. Among patients <= 55 years, the hazard ratio (HR) of the 1-year primary outcomes increased with an HbA1C > 8.0% (adjusted HR 1.39[1.13-1.70]). For patients aged 56-65 and 66-75, the highest HRs were observed for an HbA1c of 7.1-8.0% (aHRs; 1.21 [1.01-1.46] and 1.22 [1.05-1.41], respectively). In the 85+ age group, the highest HR occurred for HbA1c <= 6.0% (aHR 1.47 [0.98-2.19]). The HbA1c 8.0% showed evident age-dependent heterogeneity in the post hoc HR plots. Conclusion: Our study revealed that in patients with AIS and diabetes under 55, higher admission hbA1c was associated with an increased risk of the 1-year primary outcome, while in patients aged over 85, lower HbA1c value (<= 6.0%) may be associated with an increased risk of vascular events. The results of our study suggest the age-stratified, heterogeneous associations between admission HbA1c and 1-year vascular outcomes in patients with AIS and diabetes.

引用

页数：11

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