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Admission hyperglycemia, stroke subtypes, outcomes in acute ischemic stroke

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Author(s)
Joon-Tae KimJi Sung LeeBeom Joon KimJihoon KangKeon-Joo LeeJong-Moo ParkKyusik KangSoo Joo LeeJae Guk KimJae-Kwan ChaDae-Hyun KimTai Hwan ParkKyung Bok LeeJun LeeKeun-Sik HongYong-Jin ChoHong-Kyun ParkByung-Chul LeeKyung-Ho YuMi Sun OhDong-Eog KimJay Chol ChoiJee-Hyun KwonWook-Joo KimDong-Ick ShinKyu Sun YumSung Il SohnJeong-Ho HongSang-Hwa LeeMan-Seok ParkKang-Ho ChoiWi-Sun RyuJuneyoung LeeJeffrey L SaverHee-Joon Bae
Keimyung Author(s)
Sohn, Sung IlHong, Jeong Ho
Department
Dept. of Neurology (신경과학)
Journal Title
Diabetes Res Clin Pract
Issued Date
2023
Volume
196
Keyword
Acute ischemic strokeAdmission hyperglycemiaEarly vascular outcomeStroke subtype
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.
Keimyung Author(s)(Kor)
손성일
홍정호
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1872-8227
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0168822723000220?returnurl=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0168822723000220%3Fshowall%3Dtrue&referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
DOI
10.1016/j.diabres.2023.110257
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44836
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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