Admission Glucose and Effect of Intra-Arterial Treatment in Patients With Acute Ischemic Stroke
| العنوان: | Admission Glucose and Effect of Intra-Arterial Treatment in Patients With Acute Ischemic Stroke |
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| المؤلفون: | Osei, Elizabeth, den Hertog, Heleen M., Berkhemer, Olvert A., Fransen, Puck S. S., Roos, Yvo B. W. E. M., Beumer, Debbie, van Oostenbrugge, Robert J., Schonewille, Wouter J., Boiten, Jelis, Zandbergen, Adrienne A. M., Koudstaal, Peter J., van Zwam, Wim, Dippel, Diederik W. J. |
| المساهمون: | Neurology, MUMC+: MA AIOS Neurologie (9), MUMC+: MA Neurologie (3), RS: CARIM - R3.03 - Cerebral small vessel disease, Klinische Neurowetenschappen, RS: CARIM - R3.11 - Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, ANS - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes |
| المصدر: | Stroke, 48(5), 1299-+. Lippincott Williams & Wilkins Stroke, 48(5), 1299-1305. LIPPINCOTT WILLIAMS & WILKINS Stroke; a journal of cerebral circulation, 48(5), 1299-1305. Lippincott Williams and Wilkins |
| بيانات النشر: | Lippincott Williams & Wilkins, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Blood Glucose, Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, THERAPY, law.invention, Brain Ischemia, Brain ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, Outcome Assessment, Health Care, Medicine, Single-Blind Method, glucose, Stroke, Thrombectomy, Aged, 80 and over, OUTCOMES, BLOOD-GLUCOSE, Thrombolysis, Middle Aged, Cardiology, TRIAL, Female, Stents, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, PA, hemorrhages, medicine.medical_specialty, Prognostic variable, 03 medical and health sciences, Internal medicine, Humans, PLASMINOGEN-ACTIVATOR, Aged, Advanced and Specialized Nursing, THROMBOLYSIS, business.industry, Odds ratio, medicine.disease, Surgery, ACUTE HYPERGLYCEMIA, Clinical trial, ENDOVASCULAR TREATMENT, Hyperglycemia, Neurology (clinical), business, 030217 neurology & neurosurgery |
| الوصف: | Background and Purpose— Hyperglycemia on admission is common after ischemic stroke. It is associated with unfavorable outcome after treatment with intravenous thrombolysis and after intra-arterial treatment. Whether hyperglycemia influences the effect of reperfusion treatment is unknown. We assessed whether increased admission serum glucose modifies the effect of intra-arterial treatment in patients with acute ischemic stroke. Methods— We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands). Hyperglycemia was defined as admission serum glucose >7.8 mmol/L. The primary outcome measure was the adjusted common odds ratio for a shift in the direction of a better outcome on the modified Rankin Scale at 90 days, estimated with ordinal logistic regression. Secondary outcome variable was symptomatic intracranial hemorrhage. We assessed treatment effect modification of hyperglycemia and admission serum glucose levels with multiplicative interaction factors and adjusted for prognostic variables. Results— Four hundred eighty-seven patients were included. Mean admission serum glucose was 7.2 mmol/L (SD, 2.2). Fifty-seven of 226 patients (25%) randomized to intra-arterial treatment were hyperglycemic compared with 61 of 261 patients (23%) in the control group. The interaction of either hyperglycemia or admission serum glucose levels and treatment effect on modified Rankin Scale scores was not significant ( P =0.67 and P =0.87, respectively). The same applied for occurrence of symptomatic hemorrhage ( P =0.39 for hyperglycemia, P =0.39 for admission serum glucose). Conclusions— We found no evidence for effect modification of intra-arterial treatment by admission serum glucose in patients with acute ischemic stroke. Clinical Trial Registration— URL: www.isrctn.com . Unique identifier: ISRCTN10888758. |
| تدمد: | 1524-4628 0039-2499 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::04d141f1411b2544e6645cc537273bc2Test https://doi.org/10.1161/strokeaha.116.016071Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....04d141f1411b2544e6645cc537273bc2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244628 00392499 |
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