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Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke

Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (D...

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Autores principales: Wnuk, Marcin, Derbisz, Justyna, Drabik, Leszek, Malecki, Maciej, Slowik, Agnieszka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306150/
https://www.ncbi.nlm.nih.gov/pubmed/34300171
http://dx.doi.org/10.3390/jcm10143005
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author Wnuk, Marcin
Derbisz, Justyna
Drabik, Leszek
Malecki, Maciej
Slowik, Agnieszka
author_facet Wnuk, Marcin
Derbisz, Justyna
Drabik, Leszek
Malecki, Maciej
Slowik, Agnieszka
author_sort Wnuk, Marcin
collection PubMed
description Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (DM) was not performed. Therefore, we assessed whether fasting normoglycemia (FNG) next morning after AIS treated with IVT was associated with 90-day functional outcome in diabetic and non-diabetic patients. Methods: We retrospectively analyzed 362 AIS patients treated with IVT at The University Hospital in Krakow. FNG was defined as glucose below 5.5 mmol/L. A favorable outcome was defined as modified Rankin score (mRS) of 0–2 at day 90 after AIS onset. Results: At 3-month follow-up, FNG was associated with favorable outcome (87.5% vs. 60.8%, p < 0.001) and decreased risk of death (3.1% vs. 18.1%, p = 0.002). Independent predictors of a favorable outcome for the whole group were: younger age (HR 0.92, 95%CI 0.89–0.95), lower NIHSS score after IVT (HR 0.70, 95%CI 0.65–0.76), lower maximal systolic blood pressure within 24 h after IVT (HR 0.92, 95%CI 0.89–0.95) and FNG (HR 4.12, 95%CI 1.38–12.35). Association between FNG and mortality was found in univariable (HR 1.47, 95%CI 0.04–0.62) but not in multivariable analysis (HR 0.23, 95%CI 0.03–1.81). In subgroup analyses, FNG was an independent predictor of favorable outcome (HR 5.96, 95%CI 1.42–25.1) only in patients without DM. Conclusions: FNG next morning after IVT is an independent protective factor for a favorable long-term outcome in non-diabetic AIS patients.
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spelling pubmed-83061502021-07-25 Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke Wnuk, Marcin Derbisz, Justyna Drabik, Leszek Malecki, Maciej Slowik, Agnieszka J Clin Med Article Background: Only a few studies evaluated the role of fasting glucose levels after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Importantly, formal analysis concerning the prognostic role of fasting glucose levels in these patients with and without diabetes mellitus (DM) was not performed. Therefore, we assessed whether fasting normoglycemia (FNG) next morning after AIS treated with IVT was associated with 90-day functional outcome in diabetic and non-diabetic patients. Methods: We retrospectively analyzed 362 AIS patients treated with IVT at The University Hospital in Krakow. FNG was defined as glucose below 5.5 mmol/L. A favorable outcome was defined as modified Rankin score (mRS) of 0–2 at day 90 after AIS onset. Results: At 3-month follow-up, FNG was associated with favorable outcome (87.5% vs. 60.8%, p < 0.001) and decreased risk of death (3.1% vs. 18.1%, p = 0.002). Independent predictors of a favorable outcome for the whole group were: younger age (HR 0.92, 95%CI 0.89–0.95), lower NIHSS score after IVT (HR 0.70, 95%CI 0.65–0.76), lower maximal systolic blood pressure within 24 h after IVT (HR 0.92, 95%CI 0.89–0.95) and FNG (HR 4.12, 95%CI 1.38–12.35). Association between FNG and mortality was found in univariable (HR 1.47, 95%CI 0.04–0.62) but not in multivariable analysis (HR 0.23, 95%CI 0.03–1.81). In subgroup analyses, FNG was an independent predictor of favorable outcome (HR 5.96, 95%CI 1.42–25.1) only in patients without DM. Conclusions: FNG next morning after IVT is an independent protective factor for a favorable long-term outcome in non-diabetic AIS patients. MDPI 2021-07-06 /pmc/articles/PMC8306150/ /pubmed/34300171 http://dx.doi.org/10.3390/jcm10143005 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wnuk, Marcin
Derbisz, Justyna
Drabik, Leszek
Malecki, Maciej
Slowik, Agnieszka
Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title_full Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title_fullStr Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title_full_unstemmed Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title_short Fasting Normoglycemia after Intravenous Thrombolysis Predicts Favorable Long-Term Outcome in Non-Diabetic Patients with Acute Ischemic Stroke
title_sort fasting normoglycemia after intravenous thrombolysis predicts favorable long-term outcome in non-diabetic patients with acute ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8306150/
https://www.ncbi.nlm.nih.gov/pubmed/34300171
http://dx.doi.org/10.3390/jcm10143005
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