In Diabetes research and clinical practice ; h5-index 50.0
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 all-stroke(Pinteraction=0.003) and composite 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 all-stroke by ischemic stroke subtype. The associations of hyperglycemia with 3-month all-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.
Kim Joon-Tae, Sung Lee Ji, Joon Kim Beom, Kang Jihoon, Lee Keon-Joo, Park Jong-Moo, Kang Kyusik, Joo Lee Soo, Guk Kim Jae, Cha Jae-Kwan, Kim Dae-Hyun, Hwan Park Tai, Bok Lee Kyung, Lee Jun, Hong Keun-Sik, Cho Yong-Jin, Park Hong-Kyun, Lee Byung-Chul, Yu Kyung-Ho, Sun Oh Mi, Kim Dong-Eog, Chol Choi Jay, Kwon Jee-Hyun, Kim Wook-Joo, Shin Dong-Ick, Sun Yum Kyu, Il Sohn Sung, Hong Jeong-Ho, Lee Sang-Hwa, Park Man-Seok, Choi Kang-Ho, Ryu Wi-Sun, Lee Juneyoung, Saver Jeffrey L, Bae Hee-Joon
2023-Jan-12
acute ischemic stroke, admission hyperglycemia, early vascular outcome, stroke subtype
