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Acute-to-chronic glycemic ratio as an outcome predictor in ischemic stroke in patients with and without diabetes mellitus.
- Source :
-
Cardiovascular diabetology [Cardiovasc Diabetol] 2024 Jun 18; Vol. 23 (1), pp. 206. Date of Electronic Publication: 2024 Jun 18. - Publication Year :
- 2024
-
Abstract
- Objective: Elevated plasma glucose levels are common in patients suffering acute ischemic stroke (AIS), and acute hyperglycemia has been defined as an independent determinant of adverse outcomes. The impact of acute-to-chronic glycemic ratio (ACR) has been analyzed in other diseases, but its impact on AIS prognosis remains unclear. The main aim of this study was to assess whether the ACR was associated with a 3-month poor prognosis in patients with AIS.<br />Research, Design and Methods: Retrospective analysis of patients admitted for AIS in Hospital del Mar, Barcelona. To estimate the chronic glucose levels (CGL) we used the formula eCGL= [28.7xHbA1c (%)]-46.7. The ACR (glycemic at admission / eCGL) was calculated for all subjects. Tertile 1 was defined as: 0.28-0.92, tertile 2: 0.92-1.13 and tertile 3: > 1.13. Poor prognosis at 3 months after stroke was defined as mRS score 3-6.<br />Results: 2.774 subjects with AIS diagnosis were included. Age, presence of diabetes, previous disability (mRS), initial severity (NIHSS) and revascularization therapy were associated with poor prognosis (p values < 0.05). For each 0.1 increase in ACR, there was a 7% increase in the risk of presenting a poor outcome. The 3rd ACR tertile was independently associated with a poor prognosis and mortality. In the ROC curves, adding the ACR variable to the classical clinical model did not increase the prediction of AIS prognosis (0.786 vs. 0.781).<br />Conclusions: ACR was positively associated with a poor prognosis and mortality at 3-months follow-up after AIS. Subjects included in the 3rd ACR tertile presented a higher risk of poor prognosis and mortality. Baseline glucose or ACR did not add predictive value in comparison to only using classical clinical variables.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Retrospective Studies
Aged
Middle Aged
Risk Factors
Time Factors
Prognosis
Aged, 80 and over
Risk Assessment
Spain epidemiology
Disability Evaluation
Glycated Hemoglobin metabolism
Hyperglycemia blood
Hyperglycemia diagnosis
Hyperglycemia mortality
Hyperglycemia epidemiology
Blood Glucose metabolism
Ischemic Stroke blood
Ischemic Stroke mortality
Ischemic Stroke diagnosis
Ischemic Stroke therapy
Biomarkers blood
Predictive Value of Tests
Diabetes Mellitus blood
Diabetes Mellitus diagnosis
Diabetes Mellitus mortality
Diabetes Mellitus epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2840
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular diabetology
- Publication Type :
- Academic Journal
- Accession number :
- 38890732
- Full Text :
- https://doi.org/10.1186/s12933-024-02260-9