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Glycosylated Hemoglobin A1c Predicts Intracerebral Hemorrhage with Acute Ischemic Stroke Post-Mechanical Thrombectomy

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机构: [a]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China [b]China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China [c]The First Hospital of Qiqihar, Qiqihar, China [d]Affiliated Qiqihar Hospital, Southern Medical University, Qiqihar, China [e]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
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关键词: Acute ischemic stroke Glycosylated hemoglobin A1c Intracerebral hemorrhage Mechanical thrombectomy

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Background: Intracerebral hemorrhage, including symptomatic intracerebral hemorrhage, is a serious post-mechanical thrombectomy complication in patients with acute ischemic stroke. We aimed to determine whether glycosylated hemoglobin A1c parameters could predict intracerebral hemorrhage in this patient population. Methods: We enrolled patients with acute occlusion of the internal carotid artery or proximal middle cerebral artery and who had undergone mechanical thrombectomy. According to the glycosylated hemoglobin A1c level (%) assessed during the hospital stay, the patients were divided into two groups: > 6.5% and ≤ 6.5%. Intracerebral hemorrhage was evaluated and classified based on cranial computed tomography scans obtained within 24–48 h or when neurological conditions worsened. We assessed the outcome at the end of 90 days using the modified Rankin Scale scores. Results: Among 202 patients, 86 (42.6%) suffered intracerebral hemorrhage, while 25 (12.4%) had symptomatic intracerebral hemorrhage; 35.6% of the patients had a favorable outcome (modified Rankin Scale scores 0–2). Multivariable analysis demonstrated an association of glycosylated hemoglobin A1c > 6.5% with intracerebral hemorrhage. Furthermore, glycosylated hemoglobin A1c > 6.5% was independently associated with symptomatic intracerebral hemorrhage (OR, 2.136; 95% CI, 1.279–3.567; P = 0.004). In addition, glycosylated hemoglobin A1c > 6.5% was significantly associated with increased mortality (OR, 1.511; 95% CI, 1.042–2.191; P = 0.029) and negatively associated with favorable outcome (OR, 0.480; 95% CI, 0.296–0.781; P = 0.003) at 90 days. Conclusions: Glycosylated hemoglobin A1c is an independent predictor of intracerebral hemorrhage (specifically, symptomatic intracerebral hemorrhage) in patients with acute ischemic stroke treated with mechanical thrombectomy. Further studies are needed to validate these findings. © 2020 Elsevier Inc.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 神经科学 4 区 外周血管病
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 神经科学 4 区 外周血管病
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出版当年[2018]版:
Q4 PERIPHERAL VASCULAR DISEASE Q4 NEUROSCIENCES
最新[2023]版:
Q3 NEUROSCIENCES Q3 PERIPHERAL VASCULAR DISEASE

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第一作者机构: [a]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China [d]Affiliated Qiqihar Hospital, Southern Medical University, Qiqihar, China
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