Liying Xing1, Shuang Liu2, Yuanmeng Tian3, Han Yan3, Li Jing3, Kangjing Chen4, Fei Yan5, Yingqiu Li6, Jianfeng Lv7, Yingxian Sun8. 1. Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, PR China; Disease Control and Prevention of Liaoning Province, Shenyang, Liaoning, PR China. 2. Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, PR China. 3. Disease Control and Prevention of Liaoning Province, Shenyang, Liaoning, PR China. 4. Disease Control and Prevention of Tiexi District, Anshan, Liaoning, PR China. 5. Disease Control and Prevention of Yuanbao District, Dandong, Liaoning, PR China. 6. Disease Control and Prevention of Liaoyang County, Liaoyang, Liaoning, PR China. 7. Disease Control and Prevention of Dawa District, Panjin, Liaoning, PR China. 8. Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, PR China. Electronic address: yxsun@cmu.edu.cn.
Abstract
BACKGROUND: Limited data are available on the impact of fasting plasma glucose (FPG) on outcomes in nondiabetic acute ischemic stroke patients. METHODS: The prospective, multi-center, and observational study was performed at 8 hospitals in the Liaoning Province between 2015-2016, sought to elucidate the relationship between FPG and the 6-month functional outcomes in nondiabetic acute ischemic stroke patients. The primary effect measure was the adjusted odds ratio for a shift in the direction of unfavorable outcome on the modified Rankin Scale (mRS) score at 6 months, estimated with an ordinal logistic regression, and adjusted for common prognostic factors. Finally, we employed a restricted cubic spline function of linear model to characterize concentration-response (C-R) relationships between FPG and outcomes. RESULTS: A total of 1260 consecutive patients were enrolled, 48.9% of patients had FPG levels >6.1mmol/L. A total of 282 (22.4%) patients achieved an unfavorable neurologic outcome. Patients achieving an unfavorable neurologic outcome had significantly higher levels of FPG than those achieving a favorable neurologic outcome (6.47mmol/L versus 7.02 mmol/L). FPG was significantly related to an unfavorable neurologic outcome in nondiabetic acute ischemic stroke patients. The C-R curve showed a nonlinear relation between FPG and 6-month mRS with the nadir at 5.9mmol/L. Moreover, the likelihood of unfavorable outcome increased by 8.5% for each 1mmol/L increase in FPG. CONCLUSIONS: Early identification and prompt hyperglycemia management should be considered to improve the functional outcomes during the early poststroke stage.
BACKGROUND: Limited data are available on the impact of fasting plasma glucose (FPG) on outcomes in nondiabetic acute ischemic strokepatients. METHODS: The prospective, multi-center, and observational study was performed at 8 hospitals in the Liaoning Province between 2015-2016, sought to elucidate the relationship between FPG and the 6-month functional outcomes in nondiabetic acute ischemic strokepatients. The primary effect measure was the adjusted odds ratio for a shift in the direction of unfavorable outcome on the modified Rankin Scale (mRS) score at 6 months, estimated with an ordinal logistic regression, and adjusted for common prognostic factors. Finally, we employed a restricted cubic spline function of linear model to characterize concentration-response (C-R) relationships between FPG and outcomes. RESULTS: A total of 1260 consecutive patients were enrolled, 48.9% of patients had FPG levels >6.1mmol/L. A total of 282 (22.4%) patients achieved an unfavorable neurologic outcome. Patients achieving an unfavorable neurologic outcome had significantly higher levels of FPG than those achieving a favorable neurologic outcome (6.47mmol/L versus 7.02 mmol/L). FPG was significantly related to an unfavorable neurologic outcome in nondiabetic acute ischemic strokepatients. The C-R curve showed a nonlinear relation between FPG and 6-month mRS with the nadir at 5.9mmol/L. Moreover, the likelihood of unfavorable outcome increased by 8.5% for each 1mmol/L increase in FPG. CONCLUSIONS: Early identification and prompt hyperglycemia management should be considered to improve the functional outcomes during the early poststroke stage.