BACKGROUND AND PURPOSE: Hyperglycemia is recognized as a common occurrence associated with a high risk of poor outcome in ischaemic stroke patients. However, little is known about the association between elevated glucose level, growth of infarct volume and neurological deterioration in ischaemic stroke patients without diabetes. The present study aimed to clarify this issue in acute ischaemic stroke patients with arterial occlusion. METHODS: We studied 375 acute ischaemic stroke patients with arterial occlusion within 24 h of onset. Diabetes was diagnosed in patients with a known history of diabetes or HbA1c value ≥ 6.5%. Infarct volume was measured on admission and at follow-up within 48 h using diffusion-weighted imaging. Neurological deterioration was defined as an increase of ≥ 4 points in National Institutes of Health Stroke Scale score within 7 days of stroke onset. We examined the relationship between glucose level on admission, infarct volume growth and neurological deterioration in three categories (all patients, non-diabetes and diabetes) using multivariate modeling. RESULTS: Diabetes was present in 104 patients (27.7%). Multivariate regression analysis showed that elevated glucose level was independently associated with infarct volume growth in all patients (P = 0.034) and non-diabetes (P = 0.002), but not in diabetes (P = 0.871). Moreover, elevated glucose level was independently associated with neurological deterioration in all patients [odds ratio (OR), 1.010; 95% confidence interval (CI), 1.004-1.017; P = 0.002] and non-diabetes (OR, 1.014; 95% CI, 1.002-1.026; P = 0.022), but not diabetes (OR, 1.006; 95% CI, 0.998-1.014; P = 0.151). CONCLUSIONS: Glucose level appears to influence infarct volume growth and neurological deterioration, particularly in non-diabetic patients with ischaemic stroke.
BACKGROUND AND PURPOSE:Hyperglycemia is recognized as a common occurrence associated with a high risk of poor outcome in ischaemic strokepatients. However, little is known about the association between elevated glucose level, growth of infarct volume and neurological deterioration in ischaemic strokepatients without diabetes. The present study aimed to clarify this issue in acute ischaemic strokepatients with arterial occlusion. METHODS: We studied 375 acute ischaemic strokepatients with arterial occlusion within 24 h of onset. Diabetes was diagnosed in patients with a known history of diabetes or HbA1c value ≥ 6.5%. Infarct volume was measured on admission and at follow-up within 48 h using diffusion-weighted imaging. Neurological deterioration was defined as an increase of ≥ 4 points in National Institutes of Health Stroke Scale score within 7 days of stroke onset. We examined the relationship between glucose level on admission, infarct volume growth and neurological deterioration in three categories (all patients, non-diabetes and diabetes) using multivariate modeling. RESULTS:Diabetes was present in 104 patients (27.7%). Multivariate regression analysis showed that elevated glucose level was independently associated with infarct volume growth in all patients (P = 0.034) and non-diabetes (P = 0.002), but not in diabetes (P = 0.871). Moreover, elevated glucose level was independently associated with neurological deterioration in all patients [odds ratio (OR), 1.010; 95% confidence interval (CI), 1.004-1.017; P = 0.002] and non-diabetes (OR, 1.014; 95% CI, 1.002-1.026; P = 0.022), but not diabetes (OR, 1.006; 95% CI, 0.998-1.014; P = 0.151). CONCLUSIONS:Glucose level appears to influence infarct volume growth and neurological deterioration, particularly in non-diabeticpatients with ischaemic stroke.
Authors: Mehmet Bozbay; Huseyin Uyarel; Sahin Avsar; Ahmet Oz; Muhammed Keskin; Ahmet Murat; Adnan Kaya; Halil Atas; Ahmet Altug Cincin; Murat Ugur; Mehmet Eren Journal: Lung Date: 2016-02-19 Impact factor: 2.584
Authors: Karen C Johnston; Askiel Bruno; Qi Pauls; Christiana E Hall; Kevin M Barrett; William Barsan; Amy Fansler; Katrina Van de Bruinhorst; Scott Janis; Valerie L Durkalski-Mauldin Journal: JAMA Date: 2019-07-23 Impact factor: 56.272
Authors: Tom van Seeters; Geert Jan Biessels; L Jaap Kappelle; Irene C van der Schaaf; Jan Willem Dankbaar; Alexander D Horsch; Joris M Niesten; Merel J A Luitse; Charles B L M Majoie; Jan Albert Vos; Wouter J Schonewille; Marianne A A van Walderveen; Marieke J H Wermer; Lucien E M Duijm; Koos Keizer; Joseph C J Bot; Marieke C Visser; Aad van der Lugt; Diederik W J Dippel; F Oskar H W Kesselring; Jeannette Hofmeijer; Geert J Lycklama À Nijeholt; Jelis Boiten; Willem Jan van Rooij; Paul L M de Kort; Yvo B W E M Roos; Frederick J A Meijer; C Constantijn Pleiter; Willem P T M Mali; Yolanda van der Graaf; Birgitta K Velthuis Journal: Neuroradiology Date: 2016-01-14 Impact factor: 2.804