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Unfavorable neurological outcome in diabetic patients with acute ischemic stroke is associated with incomplete recanalization after intravenous thrombolysis.
- Source :
-
Journal of neurointerventional surgery [J Neurointerv Surg] 2016 Apr; Vol. 8 (4), pp. 342-6. Date of Electronic Publication: 2015 Mar 03. - Publication Year :
- 2016
-
Abstract
- Objective: To assess the impact of diabetes on neurological outcome and recanalization in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT).<br />Methods: Clinical data of 419 consecutive patients with AIS who received IVT between June 2009 and April 2014. Based on the medical history and new diagnosis, the patients were divided into groups with and without diabetes. Neurological outcomes at 24 h, 7 days and 3 months after IVT were evaluated. Favorable outcome was defined as National Institutes of Health Stroke Scale (NIHSS) score decrease ≥4 points from baseline or 0 at 24 h, NIHSS decrease ≥8 points or 0 at day 7, or modified Rankin scale ≤1 at 3 months after IVT. Recanalization on non-invasive imaging was evaluated in patients with large vessel occlusion (LVO) according to thrombolysis in myocardial infarction grades.<br />Results: Among 419 patients, 98 (23.4%) had diabetes. Multivariable analyses showed that comorbidity of diabetes was an independent predictor of unfavorable outcome at 24 h (OR=0.534, 95% CI 0.316 to 0.903, p=0.019), at day 7 (OR=0.382, 95% CI 0.220 to 0.665, p=0.001), and at 3 months (OR=0.464, 95% CI 0.266 to 0.808, p=0.007). In patients with LVO, diabetes was an independent predictor of incomplete recanalization 24 h after IVT (OR=0.268, 95% CI 0.075 to 0.955, p=0.042).<br />Conclusions: Diabetic patients with AIS had unfavorable neurological outcome, potentially linked to incomplete recanalization after IVT.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Subjects :
- Administration, Intravenous
Adult
Aged
Aged, 80 and over
Brain Ischemia diagnosis
Brain Ischemia epidemiology
Diabetes Mellitus diagnosis
Diabetes Mellitus epidemiology
Female
Humans
Male
Middle Aged
Reperfusion trends
Risk Factors
Stroke diagnosis
Stroke epidemiology
Thrombolytic Therapy trends
Treatment Outcome
Brain Ischemia drug therapy
Diabetes Mellitus drug therapy
Nervous System Diseases diagnosis
Nervous System Diseases epidemiology
Reperfusion methods
Stroke drug therapy
Thrombolytic Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1759-8486
- Volume :
- 8
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of neurointerventional surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25735852
- Full Text :
- https://doi.org/10.1136/neurintsurg-2014-011643