TY - JOUR
TI - Association of baseline hyperglycemia with outcomes of patients with and without diabetes with acute ischemic stroke treated with intravenous thrombolysis: A propensity score-matched analysis from the SITS-ISTR registry
AU - Tsivgoulis, G.
AU - Katsanos, A.H.
AU - Mavridis, D.
AU - Lambadiari, V.
AU - Roffe, C.
AU - MacLeod, M.J.
AU - Sevcik, P.
AU - Cappellari, M.
AU - Nevšímalová, M.
AU - Toni, D.
AU - Ahmed, N.
JO - Frontiers in Diabetes
PY - 2019
VL - 68
TODO - 9
SP - 1861-1869
PB - American Diabetes Association Inc.
SN - null
TODO - 10.2337/db19-0440
TODO - aged;  Article;  blood clot lysis;  brain hemorrhage;  brain ischemia;  clinical outcome;  correlational study;  diabetes mellitus;  diabetic patient;  female;  functional assessment;  human;  hyperglycemia;  major clinical study;  male;  mortality rate;  priority journal;  propensity score;  Rankin scale;  blood;  brain ischemia;  cerebrovascular accident;  complication;  diabetes mellitus;  fibrinolytic therapy;  glucose blood level;  hyperglycemia;  middle aged;  prognosis;  register;  treatment outcome;  very elderly, fibrinolytic agent;  tissue plasminogen activator, Aged;  Aged, 80 and over;  Blood Glucose;  Brain Ischemia;  Diabetes Mellitus;  Female;  Fibrinolytic Agents;  Humans;  Hyperglycemia;  Male;  Middle Aged;  Prognosis;  Propensity Score;  Registries;  Stroke;  Thrombolytic Therapy;  Tissue Plasminogen Activator;  Treatment Outcome
TODO - Available data from observational studies on the association of admission hyperglycemia (aHG) with outcomes of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) are contradictory, especially when stratified by diabetes mellitus (DM) history. We assessed the association of aHG (≥144 mg/dL) with outcomes stratified by DM history using propensity score-matched (PSM) data from the SITS-ISTR. The primary safety outcome was symptomatic intracranial hemorrhage (SICH); 3-month functional independence (FI) (modified Rankin Scale [mRS] scores 0-2) represented the primary efficacy outcome. Patients with and without aHG did not differ in baseline characteristics both in the non-DM (n = 12,318) and DM (n = 6,572) PSM subgroups. In the non-DM group, patients with aHG had lower 3-month FI rates (53.3% vs. 57.9%, P < 0.001), higher 3-month mortality rates (19.2% vs. 16.0%, P < 0.001), and similar symptomatic intracerebral hemorrhage (SICH) rates (1.7% vs. 1.8%, P = 0.563) compared with patients without aHG. Similarly, in the DM group, patients with aHG had lower rates of 3-month favorable functional outcome (mRS scores 0-1, 34.1% vs. 39.3%, P < 0.001) and FI (48.2% vs. 52.5%, P < 0.001), higher 3-month mortality rates (23.7% vs. 19.9%, P < 0.001), and similar SICH rates (2.2% vs. 2.7%, P = 0.224) compared with patients without aHG. In conclusion, aHG was associated with unfavorable 3-month clinical outcomes in patients with and without DM and AIS treated with IVT. © 2019 by the American Diabetes Association.
ER -