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HbA1c is associated with increased all-cause mortality in the first year after acute ischemic stroke
- Source :
- Neurological Research. 36:444-452
- Publication Year :
- 2014
- Publisher :
- Informa UK Limited, 2014.
-
Abstract
- To assess the association between baseline HbA1c and the poor outcomes within 1 year after acute ischemic stroke.Acute ischemic stroke patients with HbA1c values at baseline (n = 2186) were selected from the abnormal glucose regulation in patients with acute stroke across China study (ACROSS). Logistic regressions were performed to assess the association between HbA1c quartiles (5.5% [37 mmol/mol], 5.5 to6.1% [37 to43 mmol/mol], 6.1 to7.2% [43 to55 mmol/mol], and ≥ 7.2% [≥ 55 mmol/mol]) and the poor outcomes within 1 year. Poor outcomes were defined as all-cause mortality (modified Rankin scale [mRS] = 6) and poor functional outcome (mRS [2-6]).The risk for all-cause mortality was significantly increased in HbA1c level5.5% [37 mmol/mol] when compared to HbA1c quartile5.5% [37 mmol/mol] and dramatically increased to two to three times higher in the highest HbA1c quartile ≥ 7.2% [55 mmol/mol] (1-year all-cause mortality model, odds ratios [ORs] were 1.07, 1.01, and 2.45, P for trend 0.009). After the further analysis with previous diabetes mellitus (DM) and post-stroke insulin use stratified, the risk of mortality was increased across the HbA1c levels (P for trend 0.020) and dramatically augmented in HbA1c ≥ 7.2% [55 mmol/mol] in patients without a history of DM and without post-stroke insulin use.Elevated HbA1c (from 5.5% [37 mmol/mol]) presenting pre-stroke glycemia status has a significant trend in increasing the risk of 1-year all-cause mortality. HbA1c ≥ 7.2% (55 mmol/mol) is an independent risk predictor for 1-year all-cause mortality after acute first-ever ischemic stroke. Such an association might be altered by glycometabolism status.
- Subjects :
- Adult
Male
Risk
China
medicine.medical_specialty
Abnormal glucose
endocrine system diseases
Logistic regression
Brain Ischemia
Diabetes Complications
Internal medicine
Diabetes mellitus
Diabetes Mellitus
medicine
Humans
Hypoglycemic Agents
Insulin
In patient
Prospective Studies
Mortality
Acute ischemic stroke
Aged
Glycated Hemoglobin
business.industry
nutritional and metabolic diseases
General Medicine
Odds ratio
Middle Aged
Prognosis
medicine.disease
Stroke
Logistic Models
Neurology
Quartile
Multivariate Analysis
Physical therapy
Cardiology
Female
Neurology (clinical)
Blood Gas Analysis
business
All cause mortality
Follow-Up Studies
Subjects
Details
- ISSN :
- 17431328 and 01616412
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Neurological Research
- Accession number :
- edsair.doi.dedup.....8b4c1fd3e594dab75175936446fa9380
- Full Text :
- https://doi.org/10.1179/1743132814y.0000000355