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HbA1c is associated with increased all-cause mortality in the first year after acute ischemic stroke

Authors :
Yongjun Wang
Shuolin Wu
Kolin Hoff
Xingquan Zhao
Anxin Wang
Yilong Wang
Gaifen Liu
Chunxue Wang
Qian Jia
Xianwei Wang
Liping Liu
Chunjuan Wang
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.

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