Admission hyperglycemia, stroke subtypes, outcomes in acute ischemic stroke
- Authors
- Kim, Joon-Tae; Lee, Ji Sung; Kim, Beom Joon; Kang, Jihoon; Lee, Keon-Joo; Park, Jong-Moo; Kang, Kyusik; Lee, Soo Joo; Kim, Jae Guk; Cha, Jae-Kwan; Kim, Dae-Hyun; Park, Tai Hwan; Lee, Kyung Bok; Lee, Jun; Hong, Keun-Sik; Cho, Yong-Jin; Park, Hong-Kyun; Lee, Byung-Chul; Yu, Kyung-Ho; Oh, Mi Sun; Kim, Dong-Eog; Choi, Jay Chol; Kwon, Jee-Hyun; Kim, Wook-Joo; Shin, Dong-Ick; Yum, Kyu Sun; Il Sohn, Sung; Hong, Jeong-Ho; Lee, Sang-Hwa; Park, Man-Seok; Choi, Kang-Ho; Ryu, Wi-Sun; Lee, Juneyoung; Saver, Jeffrey L.; Bae, Hee-Joon
- Issue Date
- Feb-2023
- Publisher
- Elsevier BV
- Keywords
- Admission hyperglycemia; Stroke subtype; Acute ischemic stroke; Early vascular outcome
- Citation
- Diabetes Research and Clinical Practice, v.196
- Indexed
- SCIE
SCOPUS
- Journal Title
- Diabetes Research and Clinical Practice
- Volume
- 196
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62731
- DOI
- 10.1016/j.diabres.2023.110257
- ISSN
- 0168-8227
1872-8227
- Abstract
- Aims
Whether admission hyperglycemia is differentially associated with early vascular outcomes in acute ischemic stroke (AIS) depending on stroke subtype has been incompletely delineated.
Methods
In a multicenter, prospective stroke registry, patients with AIS were categorized based on admission glucose levels into normoglycemia, moderate hyperglycemia, and severe hyperglycemia (<140mg/dl, 140–179mg/dl, and ≥180mg/dl, respectively) groups. Multivariate analysis assessed the interaction between the hyperglycemia and ischemic stroke subtypes of large artery atherothrombosis (LAA), cardioembolism (CE), and small vessel occlusion (SVO) and early vascular outcomes (3-month stroke, all-cause mortality, and composite of stroke, MI, and all-cause mortality).
Results
Among the 32,772 patients (age:69.0±12.6yrs, male:58.4%) meeting eligibility criteria, 61.9% were in the normoglycemia group, 19.5% were in the moderate hyperglycemia group, and 18.7% were in the severe hyperglycemia group. Substantial interactions between hyperglycemia groups and stroke subtypes were observed for 3-month stroke (Pinteraction = 0.003) and composite of stroke, MI, and all-cause mortality (Pinteraction = 0.001), with differential recurrence strongest among CE, intermediate among LAA, and least among SVO.
Conclusions
Hyperglycemia was differently associated with the risk of 3-month stroke by ischemic stroke subtype. The associations of hyperglycemia with 3-month stroke were greatest in CE subtype but not in SVO subtype. These results suggest that the effect of glucose-lowering treatment after AIS may differ according to stroke subtype.
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- Appears in
Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
- 2. Clinical Science > Department of Neurology > 1. Journal Articles
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