BACKGROUND AND PURPOSE: The present study examined the effects of admission hyperglycemia and early recanalization (ER) after t-PA administration on infarct volume and patient outcome. METHODS: Acute ischemic stroke patients with major artery occlusion treated with t-PA within 3h of onset were studied prospectively. Hyperglycemia was identified as admitting blood glucose value≥130 mg/dl. We compared serial infarct volume and patient outcome between normoglycemic and hyperglycemic groups, and assessed correlation between admitting blood glucose value and △infarct volume (7 days-baseline) between patients with and without ER. RESULTS: 97 patients (ICA occlusion in 30, M1 in 44, and M2 in 23 patients) were enrolled in the present study; 52 had hyperglycemia, and 40 had ER. The initial infarct volume did not differ between the normoglycemic and hyperglycemic groups. However, infarct volume at 7 days was larger in the hyperglycemic group than in the normoglycemic group (156.2±157.1cm(3), vs. 85.4±140.7 cm(3), P=0.0061) and the baseline admitting blood glucose value was correlated with Δinfarct volume (7 days-baseline) (r=0.340, P=0.0014). Regarding ER, Δinfarct volume (7 days-baseline) in patients without ER was correlated with admitting blood glucose value(r=0.372, P=0.0078). However, in patients with ER, Δinfarct volume was not associated with admitting blood glucose value (r=0.225, P=0.1173). Good outcome (mRS 0-2) at 3 months was more frequent in normoglycemic patients than hyperglycemic patients (43.2% vs. 22.2%, P=0.0418). CONCLUSION: Admission hyperglycemia was associated with infarct volume expansion and patient outcome in t-PA patients. However, if ER occurs, hyperglycemia should not adversely affect infarct volume.
BACKGROUND AND PURPOSE: The present study examined the effects of admission hyperglycemia and early recanalization (ER) after t-PA administration on infarct volume and patient outcome. METHODS: Acute ischemic strokepatients with major artery occlusion treated with t-PA within 3h of onset were studied prospectively. Hyperglycemia was identified as admitting blood glucose value≥130 mg/dl. We compared serial infarct volume and patient outcome between normoglycemic and hyperglycemic groups, and assessed correlation between admitting blood glucose value and △infarct volume (7 days-baseline) between patients with and without ER. RESULTS: 97 patients (ICA occlusion in 30, M1 in 44, and M2 in 23 patients) were enrolled in the present study; 52 had hyperglycemia, and 40 had ER. The initial infarct volume did not differ between the normoglycemic and hyperglycemic groups. However, infarct volume at 7 days was larger in the hyperglycemic group than in the normoglycemic group (156.2±157.1cm(3), vs. 85.4±140.7 cm(3), P=0.0061) and the baseline admitting blood glucose value was correlated with Δinfarct volume (7 days-baseline) (r=0.340, P=0.0014). Regarding ER, Δinfarct volume (7 days-baseline) in patients without ER was correlated with admitting blood glucose value(r=0.372, P=0.0078). However, in patients with ER, Δinfarct volume was not associated with admitting blood glucose value (r=0.225, P=0.1173). Good outcome (mRS 0-2) at 3 months was more frequent in normoglycemic patients than hyperglycemic patients (43.2% vs. 22.2%, P=0.0418). CONCLUSION: Admission hyperglycemia was associated with infarct volume expansion and patient outcome in t-PApatients. However, if ER occurs, hyperglycemia should not adversely affect infarct volume.
Authors: Kotryna Genceviciute; Martina B Göldlin; Christoph C Kurmann; Adnan Mujanovic; Thomas R Meinel; Johannes Kaesmacher; David J Seiffge; Simon Jung; Pasquale Mordasini; Urs Fischer; Jan Gralla; Hakan Sarikaya; Barbara Goeggel Simonetti; Kateryna Antonenko; Roza M Umarova; Lia Bally; Marcel Arnold; Mirjam R Heldner Journal: Eur J Neurol Date: 2022-07-01 Impact factor: 6.288