Effect of Hyperglycemia at Presentation on Outcomes in Acute Large Artery Occlusion Patients Treated With Solitaire Stent Thrombectomy

被引：25

作者：

Huo, Xiaochuan ^{[1
]}

Liu, Raynald ^{[1
]}

Gao, Feng ^{[1
]}

Ma, Ning ^{[1
]}

Mo, Dapeng ^{[1
]}

Liao, Xiaoling ^{[2
]}

Wang, Chunjuan ^{[2
]}

Sun, Xuan ^{[1
]}

Song, Ligang ^{[1
]}

Jia, Baixue ^{[1
]}

Liu, Lian ^{[1
]}

Wang, Bo ^{[1
]}

Pan, Yuesong ^{[2
]}

Wang, Yilong ^{[2
]}

Liu, Liping ^{[2
]}

Zhao, Xingquan ^{[2
]}

Wang, Yongjun ^{[2
]}

Miao, Zhongrong ^{[1
]}

机构：

[1] Capital Med Univ, Intervent Neuroradiol Ctr, Beijing Tiantan Hosp, Beijing, Peoples R China

[2] Capital Med Univ, Dept Neurol, Beijing Tiantan Hosp, Beijing, Peoples R China

来源：

FRONTIERS IN NEUROLOGY | 2019年 / 10卷

关键词：

mechanical thrombectomy; hyperglycemia; acute ischemic stroke; stent retriever; outcomes; ACUTE ISCHEMIC-STROKE; TISSUE-PLASMINOGEN ACTIVATOR; ADMISSION HYPERGLYCEMIA; INTRAARTERIAL TREATMENT; ENDOVASCULAR THERAPY; T-PA; GLUCOSE; TRIAL; HEMORRHAGE; THROMBOLYSIS;

D O I：

10.3389/fneur.2019.00071

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Sporadic data showed hyperglycemia at presentation is associated with poor outcomes in patients with acute ischemic stroke (AIS) under mechanical thrombectomy (MT) treatment. Objective: This study aims to evaluate the relationship of admission hyperglycemia and outcomes in patients treated with solitaire stent thrombectomy. Methods: This multicenter prospective study registered patients with AIS due to anterior circulation large vessel occlusion (LVO) suitable for MT with Solitaire stent retriever. We analyzed the influence of admission hyperglycemia (>= 7.8 mmol/L) and serum glucose on functional independence which is defined as modified Rankin Scale score (mRS) of 0-2, symptomatic intracranial hemorrhage (sICH) and several outcomes of interest using univariable and multiple logistic regression analysis. Results: This study involved 17 stroke centers across China and consecutively recruited 149 patients. Patients with hyperglycemia at presentation less frequently exhibited a functional independence at 3 months than patients without hyperglycemia (22.2 vs. 66.4%; odds ratio 0.75, 95% confidence interval 0.61-0.92; P = 0.005). Higher glucose levels were correlated with worse outcome (per 1 mmol/L increase in glucose: odds ratio for mRS score 0-2 at 3 months 0.17, 95% confidence interval 0.06-0.45; P 0.001) at 3 months and sICH (per 1 mmol/L increase in glucose: odds ratio for sICH was 8.2, 95% confidence interval 1.13-29.57; P < 0.001) after thrombectomy. Conclusions: Higher admission serum glucose and hyperglycemia were independently correlated with lower functional independence at 3 months in patients treated with Solitaire stent thrombectomy of anterior circulation LVO. Higher admission serum glucose was also associated with sICH after thrombectomy.

引用

页数：8

共 29 条

[1] Effects of admission hyperglycemia on stroke outcome in reperfused tissue plasminogen activator-treated patients [J].

Alvarez-Sabín, J ;

Molina, CA ;

Montaner, J ;

Arenillas, JF ;

Huertas, R ;

Ribo, M ;

Codina, A ;

Quintana, M .

STROKE, 2003, 34 (05) :1235-1240

[2] Effects of glucose and PaO2 modulation on cortical intracellular acidosis, NADH redox state, and infarction in the ischemic penumbra [J].

Anderson, RE ;

Tan, WK ;

Martin, HS ;

Meyer, FB .

STROKE, 1999, 30 (01) :160-170

[3] Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke [J].

Arnold, Marcel ;

Mattle, Selina ;

Galimanis, Aekaterini ;

Kappeler, Liliane ;

Fischer, Urs ;

Jung, Simon ;

De Marchis, Gian Marco ;

Gralla, Jan ;

Mono, Marie-Luise ;

Brekenfeld, Caspar ;

Meier, Niklaus ;

Nedeltchev, Krassen ;

Schroth, Gerhard ;

Mattle, Heinrich P. .

INTERNATIONAL JOURNAL OF STROKE, 2014, 9 (08) :985-991

[4] A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke [J].

Berkhemer, O. A. ;

Fransen, P. S. S. ;

Beumer, D. ;

van den Berg, L. A. ;

Lingsma, H. F. ;

Yoo, A. J. ;

Schonewille, W. J. ;

Vos, J. A. ;

Nederkoorn, P. J. ;

Wermer, M. J. H. ;

van Walderveen, M. A. A. ;

Staals, J. ;

Hofmeijer, J. ;

van Oostayen, J. A. ;

Nijeholt, G. J. Lycklama A. ;

Boiten, J. ;

Brouwer, P. A. ;

Emmer, B. J. ;

de Bruijn, S. F. ;

van Dijk, L. C. ;

Kappelle, L. J. ;

Lo, R. H. ;

Van Dijk, E. J. ;

de Vries, J. ;

de Kort, P. L. M. ;

van Rooij, W. J. J. ;

van den Berg, J. S. P. ;

van Hasselt, B. A. A. M. ;

Aerden, L. A. M. ;

Dallinga, R. J. ;

Visser, M. C. ;

Bot, J. C. J. ;

Vroomen, P. C. ;

Eshghi, O. ;

Schreuder, T. H. C. M. L. ;

Heijboer, R. J. J. ;

Keizer, K. ;

Tielbeek, A. V. ;

den Hertog, H. M. ;

Gerrits, D. G. ;

van den Berg-Vos, R. M. ;

Karas, G. B. ;

Steyerberg, E. W. ;

Flach, H. Z. ;

Marquering, H. A. ;

Sprengers, M. E. S. ;

Jenniskens, S. F. M. ;

Beenen, L. F. M. ;

van den Berg, R. ;

Koudstaal, P. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (01) :11-20

[5] Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J].

Campbell, B. C. V. ;

Mitchell, P. J. ;

Kleinig, T. J. ;

Dewey, H. M. ;

Churilov, L. ;

Yassi, N. ;

Yan, B. ;

Dowling, R. J. ;

Parsons, M. W. ;

Oxley, T. J. ;

Wu, T. Y. ;

Brooks, M. ;

Simpson, M. A. ;

Miteff, F. ;

Levi, C. R. ;

Krause, M. ;

Harrington, T. J. ;

Faulder, K. C. ;

Steinfort, B. S. ;

Priglinger, M. ;

Ang, T. ;

Scroop, R. ;

Barber, P. A. ;

McGuinness, B. ;

Wijeratne, T. ;

Phan, T. G. ;

Chong, W. ;

Chandra, R. V. ;

Bladin, C. F. ;

Badve, M. ;

Rice, H. ;

de Villiers, L. ;

Ma, H. ;

Desmond, P. M. ;

Donnan, G. A. ;

Davis, S. M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1009-1018

[6] Hyperglycemia, insulin, and acute ischemic stroke - A mechanistic justification for a trial of insulin infusion therapy [J].

Garg, R ;

Chaudhuri, A ;

Munschauer, F ;

Dandona, P .

STROKE, 2006, 37 (01) :267-273

[7] Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke [J].

Goyal, M. ;

Demchuk, A. M. ;

Menon, B. K. ;

Eesa, M. ;

Rempel, J. L. ;

Thornton, J. ;

Roy, D. ;

Jovin, T. G. ;

Willinsky, R. A. ;

Sapkota, B. L. ;

Dowlatshahi, D. ;

Frei, D. F. ;

Kamal, N. R. ;

Montanera, W. J. ;

Poppe, A. Y. ;

Ryckborst, K. J. ;

Silver, F. L. ;

Shuaib, A. ;

Tampieri, D. ;

Williams, D. ;

Bang, O. Y. ;

Baxter, B. W. ;

Burns, P. A. ;

Choe, H. ;

Heo, J. -H. ;

Holmstedt, C. A. ;

Jankowitz, B. ;

Kelly, M. ;

Linares, G. ;

Mandzia, J. L. ;

Shankar, J. ;

Sohn, S. -I. ;

Swartz, R. H. ;

Barber, P. A. ;

Coutts, S. B. ;

Smith, E. E. ;

Morrish, W. F. ;

Weill, A. ;

Subramaniam, S. ;

Mitha, A. P. ;

Wong, J. H. ;

Lowerison, M. W. ;

Sajobi, T. T. ;

Hill, M. D. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (11) :1019-1030

[8] Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy [J].

Goyal, Nitin ;

Tsivgoulis, Georgios ;

Pandhi, Abhi ;

Dillard, Kira ;

Katsanos, Aristeidis H. ;

Magoufis, Georgios ;

Chang, Jason J. ;

Zand, Ramin ;

Hoit, Daniel ;

Safouris, Apostolos ;

Choudhri, Asim ;

Alexandrov, Anne W. ;

Alexandrov, Andrei V. ;

Arthur, Adam S. ;

Elijovich, Lucas .

JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2018, 10 (02) :112-+

[9] Mechanical thrombectomy and rescue therapy for intracranial large artery occlusion with underlying atherosclerosis [J].

Jia, BaiXue ;

Feng, Lei ;

Liebeskind, David S. ;

Huo, Xiaochuan ;

Gao, Feng ;

Ma, Ning ;

Mo, Dapeng ;

Liao, Xiaoling ;

Wang, Chunjuan ;

Zhao, Xingquan ;

Pan, Yuesong ;

Li, Hao ;

Liu, Liping ;

Wang, Yilong ;

Wang, Yongjun ;

Miao, Zhong-Rong .

JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2018, 10 (08) :746-+

[10] Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke [J].

Jovin, T. G. ;

Chamorro, A. ;

Cobo, E. ;

de Miquel, M. A. ;

Molina, C. A. ;

Rovira, A. ;

San Roman, L. ;

Serena, J. ;

Abilleira, S. ;

Ribo, M. ;

Millan, M. ;

Urra, X. ;

Cardona, P. ;

Lopez-Cancio, E. ;

Tomasello, A. ;

Castano, C. ;

Blasco, J. ;

Aja, L. ;

Dorado, L. ;

Quesada, H. ;

Rubiera, M. ;

Hernandez-Perez, M. ;

Goyal, M. ;

Demchuk, A. M. ;

von Kummer, R. ;

Gallofre, M. ;

Davalos, A. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (24) :2296-2306

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