The Prediction of Clinical Outcome Using HbA1c in Acute Ischemic Stroke of the Deep Branch of Middle Cerebral Artery
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To elucidate the association between glycemic control status and clinical outcomes in patients with acute ischemic stroke limited to the deep branch of the middle cerebral artery (MCA). Methods We evaluated 65 subjects with first-ever ischemic stroke of the deep branches of the MCA, which was confirmed by magnetic resonance angiography. All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c (low <7.0% or high ≥7.0%). Neurological impairment and functional status were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Korean version of Modified Barthel Index (K-MBI), Korean version of Mini-Mental State Examination (MMSE-K), and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) at admission and discharge. Body mass index, serum glucose, homocysteine and cholesterol levels were also measured at admission. Results The two groups did not show any difference in the NIHSS, FIM, K-MBI, MMSE-K, and LOTCA scores at any time point. Body mass index and levels of blood homocysteine and cholesterol were not different between the two groups. The serum blood glucose level at admission was negatively correlated with all outcome measures. Conclusion We found that HbA1c cannot be used for predication of clinical outcome in patients with ischemic stroke of the deep branch of the middle cerebral artery.
Abstract
Objective To elucidate the association between glycemic control status and clinical outcomes in patients with acute ischemic stroke limited to the deep branch of the middle cerebral artery (MCA). Methods We evaluated 65 subjects with first-ever ischemic stroke of the deep branches of the MCA, which was confirmed by magnetic resonance angiography. All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c (low <7.0% or high ≥7.0%). Neurological impairment and functional status were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Korean version of Modified Barthel Index (K-MBI), Korean version of Mini-Mental State Examination (MMSE-K), and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) at admission and discharge. Body mass index, serum glucose, homocysteine and cholesterol levels were also measured at admission. Results The two groups did not show any difference in the NIHSS, FIM, K-MBI, MMSE-K, and LOTCA scores at any time point. Body mass index and levels of blood homocysteine and cholesterol were not different between the two groups. The serum blood glucose level at admission was negatively correlated with all outcome measures. Conclusion We found that HbA1c cannot be used for predication of clinical outcome in patients with ischemic stroke of the deep branch of the middle cerebral artery.
참고문헌 (35)
- Wolfe CD., "The impact of stroke", Br Med Bull, 56, pp.275~286 (2000)
- Adams HP Jr, "Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST)", Neurology, 53, pp.126~131 (1999)
- Frankel MR, "Predicting prognosis after stroke: a placebo group analysis from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Trial", Neurology, 55, pp.952~959 (2000)
- Muir KW, "Comparison of neurological scales and scoring systems for acute stroke prognosis", Stroke, 27, pp.1817~1820 (1996)
- Andersen KK, "Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke", Stroke, 42, pp.2806~2812 (2011)
- Knoflach M, "Functional recovery after ischemic stroke: a matter of age: data from the Austrian Stroke Unit Registry", Neurology, 78, pp.279~285 (2012)
- Petty GW, "Ischemic stroke subtypes : a population-based study of functional outcome, survival, and recurrence", Stroke, 31, pp.1062~1068 (2000)
- Nedeltchev K, "Ischaemic stroke in young adults: predictors of outcome and recurrence", J Neurol Neurosurg Psychiatry, 76, pp.191~195 (2005)
- Sumer MM, "Predictors of outcome after acute ischemic stroke", Acta Neurol Scand, 107, pp.276~280 (2003)
- Saposnik G, "The iScore predicts poor functional outcomes early after hospitalization for an acute ischemic stroke", Stroke, 42, pp.3421~3428 (2011)
- Shindo A, "Diabetes and ischemic stroke", Brain Nerve, 66, pp.107~119 (2014)
- Cantu-Brito C, "Diabetes mellitus and aging as a risk factor for cerebral vascular disease: epidemiology, pathophysiology and prevention", Rev Invest Clin, 62, pp.333~342 (2010)
- Mankovsky BN, "Stroke in patients with diabetes mellitus", Diabetes Metab Res Rev, 20, pp.268~287 (2004)
- Luitse MJ, "Diabetes, hyperglycaemia, and acute ischaemic stroke", Lancet Neurol, 11, pp.261~271 (2012)
- Kruyt ND, "Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management", Nat Rev Neurol, 6, pp.145~155 (2010)
- Kamouchi M, "Prestroke glycemic control is associated with the functional outcome in acute ischemic stroke: the Fukuoka Stroke Registry", Stroke, 42, pp.2788~2794 (2011)
- Saudek CD, "Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c", JAMA, 295, pp.1688~1697 (2006)
- American Diabetes Association, "Standards of medical care in diabetes, 2014", Diabetes Care, 37(Suppl 1), pp.S14~S80 (2014)
- Rohlfing CL, "Defining the relationship between plasma glucose and HbA(1c): analysis of glucose profiles and HbA(1c) in the Diabetes Control and Complications Trial", Diabetes Care, 25, pp.275~278 (2002)
- Zoungas S, "Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds", Diabetologia, 55, pp.636~643 (2012)
- Caplan LR, "Stroke syndromes", pp.344~358 (2012), Cambridge University press
- Caplan LR., "Diabetes and brain ischemia", Diabetes, 45(Suppl 3), pp.S95~S97 (1996)
- Ghika J, "Infarcts in the territory of lenticulostriate branches from the middle cerebral artery. Etiological factors and clinical features in 65 cases", Schweiz Arch Neurol Psychiatr, 142, pp.5~18 (1991)
- Hjalmarsson C, "The role of prestrike glycemic control on severity and outcome of acute ischemic stroke", Stroke Res Treat, 2014, pp.694569~ (2014)
- Wu S, "HbA1c is associated with increased all-cause mortality in the first year after acute ischemic stroke", Neurol Res, 36, pp.444~452 (2014)
- Lei C, "Association between hemoglobin A₁C levels and clinical outcome in ischemic stroke patients with or without diabetes", J Clin Neurosci, 22, pp.498~503 (2015)
- Baird TA, "Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome", Stroke, 34, pp.2208~2214 (2003)
- Garg R, "Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy", Stroke, 37, pp.267~273 (2006)
- Williams LS, "Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke", Neurology, 59, pp.67~71 (2002)
- Weil ZM., "Ischemia-induced hyperglycemia: consequences, neuroendocrine regulation, and a role for RAGE", Horm Behav, 62, pp.280~285 (2012)
- Chmielewska B, "Value of glucose, glycosylated hemoglobin and fructosamine in blood of patients with ischemic cerebral infarction without diabetes during the early stage of the disease", Ann Univ Mariae Curie Sklodowska Med, 51, pp.61~68 (1996)
- Allport LE, "Insular cortical ischemia is independently associated with acute stress hyperglycemia", Stroke, 35, pp.1886~1891 (2004)
- Capes SE, "Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview", Stroke, 32, pp.2426~2432 (2001)
- Ogbera AO, "Glucose and lipid assessment in patients with acute stroke", Int Arch Med, 7, pp.45~ (2014)
- Murros K, "Blood glucose, glycosylated haemoglobin, and outcome of ischemic brain infarction", J Neurol Sci, 111, pp.59~64 (1992)
