Glycated hemoglobin (HbA1c) and outcome following endovascular thrombectomy for ischemic stroke.

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dc.contributor.author Diprose, William en
dc.contributor.author Wang, Michael en
dc.contributor.author McFetridge, Andrew en
dc.contributor.author Sutcliffe, James en
dc.contributor.author Barber, Peter en
dc.date.accessioned 2019-10-29T02:27:08Z en
dc.date.issued 2020-01 en
dc.identifier.issn 1759-8478 en
dc.identifier.uri http://hdl.handle.net/2292/48723 en
dc.description.abstract BACKGROUND:In ischemic stroke, increased glycated hemoglobin (HbA1c) and glucose levels are associated with worse outcome following thrombolysis, and possibly, endovascular thrombectomy. OBJECTIVE:To evaluate the association between admission HbA1c and glucose levels and outcome following endovascular thrombectomy. METHODS:Consecutive patients treated with endovascular thrombectomy with admission HbA1c and glucose levels were included. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0-2 at 3 months. Secondary outcomes included successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b-3), early neurological improvement (reduction in National Institutes of Health Stroke Scale (NIHSS) score ≥8 points, or NIHSS score of 0-1 at 24 hours), symptomatic intracerebral hemorrhage (sICH), and mortality at 3 months. RESULTS:223 patients (136 (61%) men; mean±SD age 64.5±14.6) were included. The median (IQR) HbA1c and glucose were 39 (36-45) mmol/mol and 6.9 (5.8-8.4) mmol/L, respectively. Multiple logistic regression analysis demonstrated that increasing HbA1c levels (per 10 mmol/mol) were associated with reduced functional independence (OR=0.76; 95% CI 0.60-0.96; p=0.02), increased sICH (OR=1.33; 95% CI 1.03 to 1.71; p=0.03), and increased mortality (OR=1.26; 95% CI 1.01 to 1.57; p=0.04). There were no significant associations between glucose levels and outcome measures (all p>0.05). CONCLUSIONS:HbA1c levels are an independent predictor of worse outcome following endovascular thrombectomy. The addition of HbA1c to decision-support tools for endovascular thrombectomy should be evaluated in future studies. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Journal of neurointerventional surgery en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Brain Ischemia en
dc.subject Treatment Outcome en
dc.subject Thrombectomy en
dc.subject Registries en
dc.subject Retrospective Studies en
dc.subject Prospective Studies en
dc.subject Aged en
dc.subject Aged, 80 and over en
dc.subject Middle Aged en
dc.subject Female en
dc.subject Male en
dc.subject Stroke en
dc.subject Endovascular Procedures en
dc.subject Biomarkers en
dc.subject Glycated Hemoglobin A en
dc.subject Outcome Assessment, Health Care en
dc.title Glycated hemoglobin (HbA1c) and outcome following endovascular thrombectomy for ischemic stroke. en
dc.type Journal Article en
dc.identifier.doi 10.1136/neurintsurg-2019-015023 en
pubs.issue 1 en
pubs.begin-page 30 en
pubs.volume 12 en
dc.rights.holder Copyright: The author en
pubs.end-page 32 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article en
pubs.elements-id 774437 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Ophthalmology Department en
pubs.org-id Surgery Department en
dc.identifier.eissn 1759-8486 en
pubs.record-created-at-source-date 2019-06-01 en
pubs.dimensions-id 31147437 en


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