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High glycemic variability: An underestimated determinant of stroke functional outcome following large vessel occlusion

dc.rights.licenseopenen_US
dc.contributor.authorBAUDU, J.
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorGERBAUD, Edouard
dc.contributor.authorCATARGI, B.
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorMONTAUDON, Michel
hal.structure.identifierCentre de résonance magnétique des systèmes biologiques [CRMSB]
dc.contributor.authorBEAUVIEUX, Marie Christine
dc.contributor.authorSAGNIER, S.
dc.contributor.authorDEBRUXELLES, S.
dc.contributor.authorRENOU, P.
dc.contributor.authorPOLI, M.
dc.contributor.authorOLINDO, S.
dc.contributor.authorCOUTURE, M.
hal.structure.identifierDépartement de Neuro-Radiologie [Bordeaux] [DNR - Bordeaux]
dc.contributor.authorMARNAT, G.
hal.structure.identifierInstitut de Neurosciences cognitives et intégratives d'Aquitaine [INCIA]
dc.contributor.authorSIBON, Igor
dc.date.accessioned2022-04-21T14:27:01Z
dc.date.available2022-04-21T14:27:01Z
dc.date.issued2022-02-01
dc.identifier.issn0035-3787en_US
dc.identifier.otherhttp://dx.doi.org/10.1016/j.neurol.2021.12.010en_US
dc.identifier.urioai:crossref.org:10.1016/j.neurol.2021.12.010
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/139890
dc.description.abstractEnAbstract Background and purpose Early glycemic variability (GV) in diabetic patients is a poor prognosis factor following cardiovascular events. However, its influence on the course of acute ischemic stroke (AIS) with large vessel occlusion remains unclear. We investigated the relationship between high GV during acute stroke and three-month functional outcome among patients treated with combined intravenous thrombolysis and endovascular therapy for large vessel occlusion. Methods A single-center retrospective analysis of AIS patients with proximal intracranial occlusion who underwent thrombolysis and mechanical thrombectomy between January 2015 and May 2017. Early GV was assessed using standard deviation (SD) of blood glucose levels for the first 24 hours. The main outcome was functional status at three months as defined by the modified Rankin scale (mRS). Secondary outcomes were change in NIHSS score from baseline to 24 hours and occurrence of severe hemorrhagic transformation. Multivariate logistic regression analyses including GV, admission glycemia and mean glycemia were performed. Results Among the 93 patients evaluated, 26 had early high GV (≥ 20.9 mg/dl). High GV was associated with poor functional outcome (OR = 8.00; 95%CI [1.34–47.89]; P = 0.02) unlike admission glycemia and mean glycemia (OR = 2.92; 95%CI [0.51–16.60]; P = 0.23 and OR = 0.36; 95%CI [0.05-2.6]; p = 0.31, respectively). High GV was not associated with NIHSS at 24 hours or hemorrhagic transformation. Conclusion Acute high GV contributes to poorer functional outcome following AIS related to large vessel occlusion and should be considered as a new target in acute stroke management.
dc.language.isoENen_US
dc.sourcecrossref
dc.subject.enStroke
dc.subject.enMechanical thrombectomy
dc.subject.enGlycemic variability
dc.subject.enOutcome
dc.title.enHigh glycemic variability: An underestimated determinant of stroke functional outcome following large vessel occlusion
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.neurol.2021.12.010en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalRevue Neurologiqueen_US
bordeaux.hal.laboratoriesCentre de Résonance Magnétique des Systèmes Biologiques (CRMSB) - UMR 5536en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.institutionINSERM
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcedissemin
hal.identifierhal-03648541
hal.version1
hal.date.transferred2022-04-21T14:27:06Z
hal.exporttrue
workflow.import.sourcedissemin
dc.rights.ccPas de Licence CCen_US
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