METHODS: We assessed consecutive patients with AIS between 2022 and 2023 at two large medical centers in Korea. END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. We evaluated various glycemic parameters including fasting glucose (mg/dL), hemoglobin A1c (%), and GA (%).
RESULTS: In total, 531 patients with AIS were evaluated (median age: 69 years, male sex: 66.3%). In the multivariable logistic regression analysis, GA value was positively associated with END (adjusted odds ratio [aOR] = 3.24, 95% confidence interval [CI]: 1.10-9.50). Initial NIHSS score (aOR = 1.04, 95% CI: 1.01-1.08) and thrombolytic therapy (aOR = 2.06, 95% CI: 1.14-3.73) were also associated with END. In a comparison of the predictive power of glycemic parameters for END, GA showed a higher area under the curve value on the receiver operating characteristic curve than fasting glucose and hemoglobin A1c.
CONCLUSIONS: High GA values were associated with END in patients with AIS. Furthermore, GA was a better predictor of END than fasting glucose or hemoglobin A1c.
方法:我们在韩国的两个大型医疗中心评估了2022年至2023年期间AIS的连续患者。END定义为在入院的前72小时内,美国国立卫生研究院卒中量表(NIHSS)总评分增加≥2分或运动NIHSS评分增加≥1分。我们评估了各种血糖参数,包括空腹血糖(mg/dL),血红蛋白A1c(%),GA(%)。
结果:总计,对531例AIS患者进行了评估(中位年龄:69岁,男性:66.3%)。在多变量逻辑回归分析中,GA值与END呈正相关(校正比值比[aOR]=3.24,95%置信区间[CI]:1.10-9.50)。初始NIHSS评分(aOR=1.04,95%CI:1.01-1.08)和溶栓治疗(aOR=2.06,95%CI:1.14-3.73)也与END相关。在对END的血糖参数的预测能力的比较中,GA在受试者工作特征曲线上显示出比空腹血糖和血红蛋白A1c更高的曲线下面积。
结论:高GA值与AIS患者的END相关。此外,GA比空腹血糖或血红蛋白A1c更好地预测END。