Year: 2026
Type: article
Abstract: Background and Purpose: Admission hyperglycemia is associated with poor outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke, but whether post-EVT glycemic pattern determines functional outcome remains unknown. Methods: A Retrospective Study for the Prediction of Clinical Outcomes in Acute Ischemic Stroke Patients with Thrombectomy study was a hybrid prospective-retrospective multicenter cohort study nested within the Rescue on Reperfusion Damage in Cerebral Infarction by Nelonemdaz trial (NCT05041010) across 24 tertiary stroke centers in South Korea. Patients with ≥80% measurements within 80-140 mg/dL and no value ≥200 mg/dL were classified as normoglycemic (Group 1); the remainder were classified by group-based trajectory modeling into persistently elevated (Group 2) and variable hyperglycemia (Group 3). The primary outcome was 3-month modified Rankin Scale (mRS) distribution. Results: Among 457 patients, 319 were included (mean age 73.6±12.2 years; 53.6% male): 97 (30.4%) in Group 1, 159 (49.8%) in Group 2, and 63 (19.7%) in Group 3. Groups 2 and 3 had more diabetes and higher hemoglobin A1c; stroke severity, Alberta Stroke Program Early Computed Tomography Scores, and reperfusion status were comparable. Both hyperglycemic groups had lower odds of a favorable mRS shift than Group 1 (adjusted common odds ratio [OR] 0.35, 95% confidence interval [CI] 0.20-0.61 and 0.49, 0.25-0.94). Functional independence (mRS 0-2) was achieved in 63.9% of Group 1 versus 36.5% and 38.1% in Groups 2 and 3 (adjusted OR 0.26, 95% CI 0.13-0.53 and 0.31, 0.13-0.73). No significant difference was observed between Groups 2 and 3. Conclusions: Five-day post-EVT hyperglycemic status was independently associated with worse 3-month functional outcomes beyond chronic glycemic burden, supporting re-evaluation of targeted glycemic interventions during this vulnerable window.
Source: Journal of Stroke
Authors: Kwanju Song, Ji Sung Lee, Hyun Goo Kang, Seong Hwan Ahn, Tae-Jin Song, Dong-Ick Shin, Hee-Joon Bae, Chang Hun Kim, Sung Hyuk Heo, Jin Soo Lee, Jae-Kwan Cha, Yeong Bae Lee, Eung Gyu Kim, Man Seok Park, Hee-Kwon Park, Jinkwon Kim, Sungwook Yu, Heejung Mo, Sung Il Sohn, Jee Hyun Kwon, Jae Guk Kim, Young Seo Kim, Jay Chol Choi, Yang-Ha Hwang, Keun Hwa Jung, Soo-Kyoung Kim, Woo Keun Seo, Jung Hwa Seo, Joonsang Yoo, Jun Young Chang, Mooseok Park, Wookjin Yang, Bum Joon Kim, Sun U. Kwon
Institutions: Asan Medical Center, University of Ulsan, Ajou University Hospital, Ajou University Medical Center, Ajou University, Jeonbuk National University Hospital, Jeonbuk National University, Chosun University, Chosun University Hospital, Ewha Womans University, Ewha Womans University Seoul Hospital, Chungbuk National University, Chungbuk National University Hospital, Seoul National University, Seoul National University Bundang Hospital, Gyeongsang National University, Gyeongsang National University Hospital, Kyung Hee University, Kyung Hee University Medical Center, Dong-A University Hospital, Dong-A University, Gachon University, Gachon University Gil Medical Center, Inje University Busan Paik Hospital, Chonnam National University, Chonnam National University Hospital, Inha University, Inha University Hospital, Yonsei University, Daejeon Eulji Medical Center, Eulji University, Yongin Severance Hospital, Korea University Anam Hospital, Hallym University, Hallym University Dongtan Sacred Heart Hospital, Keimyung University Daegu Dongsan Hospital, Keimyung University Dongsan Hospital, Keimyung University, Ulsan University Hospital, Wonkwang University Hospital, Wonkwang University, Jeju National University Hospital, Jeju National University, Kyungpook National University Hospital, Kyungpook National University, Seoul National University Hospital, Samsung Medical Center, Sungkyunkwan University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funder: Ministry of Health and Welfare
OpenAlex ID: W7220651111