Hyperglycemia Impacts Functional Outcomes After Endovascular Thrombectomy

This article originally appeared here.
Share this content:
The effect of hypoglycemia on functional outcomes after endovascular thrombectomy differs depending on collateral status.
The effect of hypoglycemia on functional outcomes after endovascular thrombectomy differs depending on collateral status.
The following article is part of live conference coverage from the 2017 American Academy of Neurology (AAN) annual meeting in Boston, Massachusetts. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2017.

Hyperglycemia may affect functional outcome after endovascular thrombectomy, depending on collateral status at the time of acute ischemic stroke, according to data presented at the 2017 American Academy of Neurology Annual Meeting in Boston, Massachusetts, April 22 to 28.

A multi-international team of researchers hypothesized that the effect of hyperglycemia on functional outcome and reperfusion may differ according to collateral status. The researchers collected patient data from 3 stent retriever trials and registries. A total of 309 patients (mean age, 67 years; mean presenting glucose, 131±55 mg/dL) had available angiographic data on collaterals.

Angiograms were scored for collateral grades using the American Society of Intervention and Therapeutic Neuroradiology (ASITN) scale. The median pretreatment collateral score was 2, and 35% of patients had good collaterals (grade 3-4).

More than 77% of patients had substantial reperfusion, and more than 50% had good outcomes at 90 days (modified Rankin scale, 0-2). Although glucose levels were not associated with collateral status or reperfusion, lower levels were observed in patients with good final outcomes (124 vs 140 mg/dL; P =.01).

Ultimately, collateral status altered the effect of glucose on outcomes. For example, in patients with poor collaterals, higher glucose did not alter outcomes (per 10 mg/dL increase: odds ratio [OR], 0.98; 95% CI, 0.92-1.04; P =.46), but in patients with good collaterals, high glucose levels reduced the probability of good outcomes (per 10 mg/dL increase: OR, 0.81; 95% CI, 0.69-0.95; P =.012).

"Higher glucose levels reduce likelihood of good outcome among patients with good collaterals, but do not affect outcome among patients with poor collaterals," the researchers concluded.

Visit Neurology Advisor's conference section for continuous coverage live from AAN 2017.

Reference

Kim J-T, Liebeskind D, Jahan R, Menon B, Nogueira R, Saver J. Impact of hypoglycemia according to collateral status on reperfusion and outcomes in acute ischemic stroke after mechanical thrombectomy. Presented at: 2017 American Academy of Neurology Annual Meeting. April 22-28, 2017; Boston, MA. 

You must be a registered member of Neurology Advisor to post a comment.
close

Next Article in AAN 2017 Coverage

Upcoming Meetings

Sign Up for Free e-newsletters