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      Association of Baseline Hyperglycemia With Outcomes of Patients With and Without Diabetes With Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Propensity Score–Matched Analysis From the SITS-ISTR Registry

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          Abstract

          <p class="first" id="d4700015e255">Available data from observational studies on the association of admission hyperglycemia (aHG) with outcomes of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) are contradictory, especially when stratified by diabetes mellitus (DM) history. We assessed the association of aHG (≥144 mg/dL) with outcomes stratified by DM history using propensity score-matched (PSM) data from the SITS-ISTR. The primary safety outcome was symptomatic intracranial hemorrhage (SICH); 3-month functional independence (FI) (modified Rankin Scale [mRS] scores 0-2) represented the primary efficacy outcome. Patients with and without aHG did not differ in baseline characteristics both in the non-DM (n = 12,318) and DM (n = 6,572) PSM subgroups. In the non-DM group, patients with aHG had lower 3-month FI rates (53.3% vs. 57.9%, P &lt; 0.001), higher 3-month mortality rates (19.2% vs. 16.0%, P &lt; 0.001), and similar symptomatic intracerebral hemorrhage (SICH) rates (1.7% vs. 1.8%, P = 0.563) compared with patients without aHG. Similarly, in the DM group, patients with aHG had lower rates of 3-month favorable functional outcome (mRS scores 0-1, 34.1% vs. 39.3%, P &lt; 0.001) and FI (48.2% vs. 52.5%, P &lt; 0.001), higher 3-month mortality rates (23.7% vs. 19.9%, P &lt; 0.001), and similar SICH rates (2.2% vs. 2.7%, P = 0.224) compared with patients without aHG. In conclusion, aHG was associated with unfavorable 3-month clinical outcomes in patients with and without DM and AIS treated with IVT. </p>

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          Journal
          Diabetes
          Diabetes
          American Diabetes Association
          0012-1797
          1939-327X
          August 20 2019
          September 2019
          September 2019
          June 19 2019
          : 68
          : 9
          : 1861-1869
          Article
          10.2337/db19-0440
          31217175
          de0ca769-bf24-4a55-ad83-882401825a84
          © 2019

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