Clinical Significance of Stress Hyperglycemic Ratio and Glycemic Gap in Ischemic Stroke Patients Treated with Intravenous Thrombolysis

Clin Interv Aging. 2022 Dec 14:17:1841-1849. doi: 10.2147/CIA.S393952. eCollection 2022.

Abstract

Objective: The clinical significance of different glycemic parameters has been rarely investigated in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA). This study was aimed to investigate the association between different glycemic parameters and favorable functional outcome in patients treated with IV tPA.

Methods: Patients with ischemic stroke who received IV tPA therapy at our stroke center were retrospectively enrolled. Four glycemic parameters were collected including admission glucose, HbA1c, stress hyperglycemia ratio (SHR) and glycemic gap (GG). Additional information was also recorded including demographics, medical history, stroke severity, imaging measures and mRS score at discharge. We used 5 machine learning models to investigate the predictive value of glycemic parameters.

Results: Our study included 294 patients treated with IV tPA. SHR and GG were independently associated with favorable functional outcome (adjusted OR for SHR 0.03, 95% CI 0.01-0.72, P = 0.03; adjusted OR for GG 1.024, 95% CI 1.00-1.05, P = 0.04).

Conclusion: SHR and GG were associated with functional outcomes in acute ischemic stroke patients with intravenous thrombolysis.

Keywords: glucose; hyperglycemia; stroke; thrombolysis; tissue plasminogen activator.

MeSH terms

  • Brain Ischemia* / complications
  • Brain Ischemia* / diagnostic imaging
  • Brain Ischemia* / drug therapy
  • Clinical Relevance
  • Fibrinolytic Agents
  • Humans
  • Hyperglycemia* / complications
  • Ischemic Stroke* / complications
  • Ischemic Stroke* / diagnostic imaging
  • Ischemic Stroke* / drug therapy
  • Retrospective Studies
  • Stroke* / diagnostic imaging
  • Stroke* / drug therapy
  • Thrombolytic Therapy / methods
  • Tissue Plasminogen Activator
  • Treatment Outcome

Substances

  • Tissue Plasminogen Activator
  • Fibrinolytic Agents

Grants and funding

This work was supported by grants from Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2019-I2M-5-029), the National Natural Science Foundation (82171272), Beijing Municipal Science & Technology Commission (Z211100003521019), Beijing Hospitals Authority (PX2022019), Ministry of Finance of the People’s Republic of China [issued by Finance and Social Security [2015] Document No. 82; [2016] Document No. 50; [2017] Document No. 72; [2018] Document No. 48; [2019] Document No. 77; [2020] Document No. 75; [2021] Document No. 84, Ministry of Finance], Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support, code: 202112.