Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis
Abstract Backgrounds Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influ...
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doaj-eaabb74acab943c6a94ac82ac44a2e512021-02-14T12:23:47ZengBMCBMC Neurology1471-23772021-02-012111610.1186/s12883-021-02102-1Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysisByoung-Gwon Kim0Ga Yeon Kim1Jae-Kwan Cha2Department of Preventive Medicine, College Of Medicine, Dong-A UniversityStroke Center, Department of Neurology, College of Medicine, Dong-A UniversityStroke Center, Department of Neurology, College of Medicine, Dong-A UniversityAbstract Backgrounds Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influences the patients’ short and long-term outcomes for AIS using IV thrombolysis. Methods We enrolled 661 AIS patients with IV thrombolysis. Based on the 2010 ADA guidelines, patients were classified as pre-diabetes, with HbA1c levels of 5.7–6.4%; diabetes, with HbA1c levels more than 6.5%; and NGM (normal glucose metabolism), with HbA1c levels less than 5.7%. We investigated short-term outcomes, including early neurologic deterioration (END), in-hospital death, and poor functional outcomes (mRS > 2) at 90 days. As for long-term outcomes, poor functional outcomes were measured at 1 year. Results Of the 661 AIS patients treated with IV thrombolysis, 197 patients (29.8%) were diagnosed with pre-diabetes, and 210 (31.8%) were diagnosed with diabetes. In a multivariate analysis, pre-diabetes was an independent predictor for END (OR = 2.02; 95% CI 1.12–3.62; p = 0.02) and in-hospital death (OR = 3.12; 95% CI 1.06–9.09; p = 0.04). On the other hand, diabetes was a significant independent factor for poor long-term outcomes (OR = 1.75; 95% CI 1.09–2.78; p = 0.02) after correcting confounding factors. Conclusions Unlike diabetes, pre-diabetes can be an important predictor of short-term outcomes after AIS. However, a more detailed research is needed to specify the precise mechanisms through which pre-diabetes affects the prognosis of acute ischemic stroke.https://doi.org/10.1186/s12883-021-02102-1StrokeThrombolysisDiabetesPre-diabetes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Byoung-Gwon Kim Ga Yeon Kim Jae-Kwan Cha |
spellingShingle |
Byoung-Gwon Kim Ga Yeon Kim Jae-Kwan Cha Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis BMC Neurology Stroke Thrombolysis Diabetes Pre-diabetes |
author_facet |
Byoung-Gwon Kim Ga Yeon Kim Jae-Kwan Cha |
author_sort |
Byoung-Gwon Kim |
title |
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis |
title_short |
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis |
title_full |
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis |
title_fullStr |
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis |
title_full_unstemmed |
Pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using IV thrombolysis |
title_sort |
pre-diabetes is a predictor of short-term poor outcomes after acute ischemic stroke using iv thrombolysis |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2021-02-01 |
description |
Abstract Backgrounds Pre-diabetes is an intermediate state between normal glucose metabolism and diabetes. Recent studies suggest that the presence of pre-diabetes is associated with poor outcomes after AIS. However, the results have been controversial. This study examines whether pre-diabetes influences the patients’ short and long-term outcomes for AIS using IV thrombolysis. Methods We enrolled 661 AIS patients with IV thrombolysis. Based on the 2010 ADA guidelines, patients were classified as pre-diabetes, with HbA1c levels of 5.7–6.4%; diabetes, with HbA1c levels more than 6.5%; and NGM (normal glucose metabolism), with HbA1c levels less than 5.7%. We investigated short-term outcomes, including early neurologic deterioration (END), in-hospital death, and poor functional outcomes (mRS > 2) at 90 days. As for long-term outcomes, poor functional outcomes were measured at 1 year. Results Of the 661 AIS patients treated with IV thrombolysis, 197 patients (29.8%) were diagnosed with pre-diabetes, and 210 (31.8%) were diagnosed with diabetes. In a multivariate analysis, pre-diabetes was an independent predictor for END (OR = 2.02; 95% CI 1.12–3.62; p = 0.02) and in-hospital death (OR = 3.12; 95% CI 1.06–9.09; p = 0.04). On the other hand, diabetes was a significant independent factor for poor long-term outcomes (OR = 1.75; 95% CI 1.09–2.78; p = 0.02) after correcting confounding factors. Conclusions Unlike diabetes, pre-diabetes can be an important predictor of short-term outcomes after AIS. However, a more detailed research is needed to specify the precise mechanisms through which pre-diabetes affects the prognosis of acute ischemic stroke. |
topic |
Stroke Thrombolysis Diabetes Pre-diabetes |
url |
https://doi.org/10.1186/s12883-021-02102-1 |
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