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Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.

Abstract Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.
PMID
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Authors

Mayor MeshTerms
Keywords

acute stroke therapy

diabetes

glucose

intra-arterial thrombolysis

outcome

recanalization

Journal Title international journal of stroke : official journal of the international stroke society
Publication Year Start
%A Arnold, Marcel; Mattle, Selina; Galimanis, Aekaterini; Kappeler, Liliane; Fischer, Urs; Jung, Simon; De Marchis, Gian Marco; Gralla, Jan; Mono, Marie-Luise; Brekenfeld, Caspar; Meier, Niklaus; Nedeltchev, Krassen; Schroth, Gerhard; Mattle, Heinrich P.
%T Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.
%J International journal of stroke : official journal of the International Stroke Society, vol. 9, no. 8, pp. 985-991
%D 12/2014
%V 9
%N 8
%M eng
%B Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.
%K Aged, Brain Ischemia, Diabetes Mellitus, Female, Glucose, Humans, Injections, Intra-Arterial, Intracranial Hemorrhages, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Retrospective Studies, Stroke, Thrombolytic Therapy, Treatment Outcome
%P 985
%L 991
%Y 10.1111/j.1747-4949.2012.00879.x
%W PHY
%G AUTHOR
%R 2014........9..985A

@Article{Arnold2014,
author="Arnold, Marcel
and Mattle, Selina
and Galimanis, Aekaterini
and Kappeler, Liliane
and Fischer, Urs
and Jung, Simon
and De Marchis, Gian Marco
and Gralla, Jan
and Mono, Marie-Luise
and Brekenfeld, Caspar
and Meier, Niklaus
and Nedeltchev, Krassen
and Schroth, Gerhard
and Mattle, Heinrich P.",
title="Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.",
journal="International journal of stroke : official journal of the International Stroke Society",
year="2014",
month="Dec",
day="13",
volume="9",
number="8",
pages="985--991",
keywords="Aged",
keywords="Brain Ischemia",
keywords="Diabetes Mellitus",
keywords="Female",
keywords="Glucose",
keywords="Humans",
keywords="Injections, Intra-Arterial",
keywords="Intracranial Hemorrhages",
keywords="Magnetic Resonance Angiography",
keywords="Magnetic Resonance Imaging",
keywords="Male",
keywords="Middle Aged",
keywords="Prospective Studies",
keywords="Retrospective Studies",
keywords="Stroke",
keywords="Thrombolytic Therapy",
keywords="Treatment Outcome",
abstract="Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.",
issn="1747-4949",
doi="10.1111/j.1747-4949.2012.00879.x",
url="http://www.ncbi.nlm.nih.gov/pubmed/22973986",
language="eng"
}

%0 Journal Article
%T Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.
%A Arnold, Marcel
%A Mattle, Selina
%A Galimanis, Aekaterini
%A Kappeler, Liliane
%A Fischer, Urs
%A Jung, Simon
%A De Marchis, Gian Marco
%A Gralla, Jan
%A Mono, Marie-Luise
%A Brekenfeld, Caspar
%A Meier, Niklaus
%A Nedeltchev, Krassen
%A Schroth, Gerhard
%A Mattle, Heinrich P.
%J International journal of stroke : official journal of the International Stroke Society
%D 2014
%8 Dec 13
%V 9
%N 8
%@ 1747-4949
%G eng
%F Arnold2014
%X Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.
%K Aged
%K Brain Ischemia
%K Diabetes Mellitus
%K Female
%K Glucose
%K Humans
%K Injections, Intra-Arterial
%K Intracranial Hemorrhages
%K Magnetic Resonance Angiography
%K Magnetic Resonance Imaging
%K Male
%K Middle Aged
%K Prospective Studies
%K Retrospective Studies
%K Stroke
%K Thrombolytic Therapy
%K Treatment Outcome
%U http://dx.doi.org/10.1111/j.1747-4949.2012.00879.x
%U http://www.ncbi.nlm.nih.gov/pubmed/22973986
%P 985-991

PT Journal
AU Arnold, M
   Mattle, S
   Galimanis, A
   Kappeler, L
   Fischer, U
   Jung, S
   De Marchis, GM
   Gralla, J
   Mono, M
   Brekenfeld, C
   Meier, N
   Nedeltchev, K
   Schroth, G
   Mattle, HP
TI Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.
SO International journal of stroke : official journal of the International Stroke Society
JI Int J Stroke
PD Dec
PY 2014
BP 985
EP 991
VL 9
IS 8
DI 10.1111/j.1747-4949.2012.00879.x
LA eng
DE Aged; Brain Ischemia; Diabetes Mellitus; Female; Glucose; Humans; Injections, Intra-Arterial; Intracranial Hemorrhages; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Middle Aged; Prospective Studies; Retrospective Studies; Stroke; Thrombolytic Therapy; Treatment Outcome
AB Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.
ER

PMID- 22973986
OWN - NLM
STAT- MEDLINE
DA  - 20141110
DCOM- 20150629
IS  - 1747-4949 (Electronic)
IS  - 1747-4930 (Linking)
VI  - 9
IP  - 8
DP  - 2014 Dec
TI  - Impact of admission glucose and diabetes on recanalization and outcome after
      intra-arterial thrombolysis for ischaemic stroke.
PG  - 985-91
LID - 10.1111/j.1747-4949.2012.00879.x [doi]
AB  - BACKGROUND: Stroke patients with diabetes and admission hyperglycaemia have worse
      outcomes than non-diabetics, with or without intravenous thrombolysis. Poor
      vessel recanalization was reported in diabetics treated with intravenous
      thrombolysis. AIMS: This study aimed to determine the impact of admission glucose
      and diabetes on recanalization and outcome after intra-arterial thrombolysis.
      METHODS: We analysed 389 patients (213 men, 176 women) treated with
      intra-arterial thrombolysis. The association of diabetes and admission glucose
      value with recanalization, outcome, mortality, and symptomatic intracranial
      haemorrhage was determined. Recanalization was classified according to
      thrombolysis in myocardial infarction grades. Outcome was measured using the
      modified Rankin Scale at three-months and categorized as favourable (modified
      Rankin Scale 0-2) or poor (modified Rankin Scale 3-6). RESULTS: The rate of
      partial or complete recanalization (thrombolysis in myocardial infarction 2-3)
      did not differ between patients with and without diabetes (67% vs. 66%; P =
      1.000). Mean admission glucose values were similar in patients with poor
      recanalization (thrombolysis in myocardial infarction 0-1) and patients with
      partial or complete recanalization (thrombolysis in myocardial infarction 2-3;
      7.3 vs. 7.3 mmol/l; P = 0.746). Follow-up at three-months was obtained in 388 of 
      389 patients. Clinical outcome was favourable (modified Rankin Scale 0-2) in 189 
      patients (49%) and poor (modified Rankin Scale 3-6) in 199 patients (51%).
      Mortality at three-months was 20%. Diabetics were more likely to have poor
      outcome (72% vs. 48%; P = 0.001) and to be dead (30% vs. 19%; P = 0.044) at
      three-months. After multivariable analysis, there remained an independent
      relationship between diabetes and outcome (P = 0.003; odds ratio 3.033, 95%
      confidence interval 1.452-6.336), but not with mortality (P = 0.310; odds ratio
      1.436; 95% confidence interval 0.714-2.888). Moreover, higher age (P = 0.001;
      odds ratio 1.039; 95% confidence interval 1.017-1.061), higher baseline National 
      Institutes of Health Stroke Scale score (P < 0.0001; odds ratio 1.130; 95%
      confidence interval 1.079-1.182), location of vessel occlusion as categorical
      variable (P < 0.0001), poor collaterals (P = 0.02; odds ratio 1.587; 95%
      confidence interval 1.076-2.341), poor vessel recanalization (P < 0.0001; odds
      ratio 4.713; 95% confidence interval 2.627-8.454), and higher leucocyte count (P 
      = 0.032; odds ratio 1.094; 95% confidence interval 1.008-1.188) were independent 
      baseline predictors of poor outcome. Higher admission glucose was associated with
      poor outcome (P = 0.006) and mortality (P < 0.0001). After multivariate analyses,
      glucose remained independently associated with poor outcome (P = 0.019; odds
      ratio 1.150; 95% confidence interval 1.023-1-292) and mortality (P = 0.005; odds 
      ratio 1.183; 95% confidence interval 1052-1.331). The rate of symptomatic
      intracranial haemorrhage was similar in diabetics and non-diabetics (6.7% vs.
      4.6%; P = 0.512). Mean admission glucose was higher in patients with symptomatic 
      intracranial haemorrhage than without (8.58 vs. 7.26 mmol/l; P = 0.010).
      Multivariable analysis confirmed an independent association between admission
      glucose and symptomatic intracranial haemorrhage (P = 0.027; odds ratio 1.187;
      95% confidence interval 1.020-1.381). CONCLUSIONS: Diabetes and glucose value on 
      admission did not influence recanalization after intra-arterial thrombolysis;
      nevertheless, they were independent predictors of poor outcome after
      intra-arterial thrombolysis and a higher admission glucose value was an
      independent predictor of symptomatic intracranial haemorrhage. This indicates
      that factors on the capillary, cellular, or metabolic level may account for the
      worse outcome in patients with elevated glucose value and diabetes.
CI  - (c) 2012 The Authors. International Journal of Stroke (c) 2012 World Stroke
      Organization.
FAU - Arnold, Marcel
AU  - Arnold M
AD  - Department of Neurology, University Bern, Bern, Switzerland.
FAU - Mattle, Selina
AU  - Mattle S
FAU - Galimanis, Aekaterini
AU  - Galimanis A
FAU - Kappeler, Liliane
AU  - Kappeler L
FAU - Fischer, Urs
AU  - Fischer U
FAU - Jung, Simon
AU  - Jung S
FAU - De Marchis, Gian Marco
AU  - De Marchis GM
FAU - Gralla, Jan
AU  - Gralla J
FAU - Mono, Marie-Luise
AU  - Mono ML
FAU - Brekenfeld, Caspar
AU  - Brekenfeld C
FAU - Meier, Niklaus
AU  - Meier N
FAU - Nedeltchev, Krassen
AU  - Nedeltchev K
FAU - Schroth, Gerhard
AU  - Schroth G
FAU - Mattle, Heinrich P
AU  - Mattle HP
LA  - eng
PT  - Journal Article
DEP - 20120913
PL  - England
TA  - Int J Stroke
JT  - International journal of stroke : official journal of the International Stroke
      Society
JID - 101274068
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Aged
MH  - Brain Ischemia/complications
MH  - Diabetes Mellitus/*drug therapy
MH  - Female
MH  - Glucose/*administration & dosage
MH  - Humans
MH  - Injections, Intra-Arterial/methods
MH  - Intracranial Hemorrhages/etiology
MH  - Magnetic Resonance Angiography
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Stroke/*complications/etiology/mortality/*therapy
MH  - Thrombolytic Therapy/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - acute stroke therapy
OT  - diabetes
OT  - glucose
OT  - intra-arterial thrombolysis
OT  - outcome
OT  - recanalization
EDAT- 2012/09/15 06:00
MHDA- 2015/06/30 06:00
CRDT- 2012/09/15 06:00
PHST- 2012/09/13 [aheadofprint]
AID - 10.1111/j.1747-4949.2012.00879.x [doi]
PST - ppublish
SO  - Int J Stroke. 2014 Dec;9(8):985-91. doi: 10.1111/j.1747-4949.2012.00879.x. Epub
      2012 Sep 13.
TY  - JOUR
AU  - Arnold, Marcel
AU  - Mattle, Selina
AU  - Galimanis, Aekaterini
AU  - Kappeler, Liliane
AU  - Fischer, Urs
AU  - Jung, Simon
AU  - De Marchis, Gian Marco
AU  - Gralla, Jan
AU  - Mono, Marie-Luise
AU  - Brekenfeld, Caspar
AU  - Meier, Niklaus
AU  - Nedeltchev, Krassen
AU  - Schroth, Gerhard
AU  - Mattle, Heinrich P.
PY  - 2014/Dec/13
TI  - Impact of admission glucose and diabetes on recanalization and outcome after intra-arterial thrombolysis for ischaemic stroke.
T2  - Int J Stroke
JO  - International journal of stroke : official journal of the International Stroke Society
SP  - 985
EP  - 991
VL  - 9
IS  - 8
KW  - Aged
KW  - Brain Ischemia
KW  - Diabetes Mellitus
KW  - Female
KW  - Glucose
KW  - Humans
KW  - Injections, Intra-Arterial
KW  - Intracranial Hemorrhages
KW  - Magnetic Resonance Angiography
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Middle Aged
KW  - Prospective Studies
KW  - Retrospective Studies
KW  - Stroke
KW  - Thrombolytic Therapy
KW  - Treatment Outcome
N2  - Stroke patients with diabetes and admission hyperglycaemia have worse outcomes than non-diabetics, with or without intravenous thrombolysis. Poor vessel recanalization was reported in diabetics treated with intravenous thrombolysis.
SN  - 1747-4949
UR  - http://dx.doi.org/10.1111/j.1747-4949.2012.00879.x
UR  - http://www.ncbi.nlm.nih.gov/pubmed/22973986
ID  - Arnold2014
ER  - 
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