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Glycated hemoglobin value combined with initial glucose levels for evaluating mortality risk in patients with ischemic stroke.

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dc.contributor.author Roquer, Jaume
dc.contributor.author Giralt-Steinhauer, Eva
dc.contributor.author Cerdà, Georgina
dc.contributor.author Rodríguez Campello, Ana María
dc.contributor.author Cuadrado Godia, Elisa
dc.contributor.author Jiménez Conde, Jordi
dc.contributor.author Vivanco Hidalgo, Rosa María
dc.contributor.author Soriano Tarraga, Carolina
dc.contributor.author Roman Degano, Irene
dc.contributor.author Ois Santiago, Angel Javier
dc.date.accessioned 2016-03-03T07:44:57Z
dc.date.available 2016-03-03T07:44:57Z
dc.date.issued 2015
dc.identifier.citation Roquer J, Giralt-Steinhauer E, Cerdà G, Rodríguez-Campello A, Cuadrado-Godia E, Jiménez-Conde J. et al. Glycated hemoglobin value combined with initial glucose levels for evaluating mortality risk in patients with ischemic stroke. Cerebrovasc Dis. 2015;40(5-6):244-50. doi: 10.1159/000440735.
dc.identifier.issn 1015-9770
dc.identifier.uri http://hdl.handle.net/10230/25965
dc.description.abstract BACKGROUND: Hyperglycemia is a marker of poor outcome in acute ischemic stroke (IS) patients. We aimed at evaluating the effect of combined HbA1c and first glucose measurement values on 3-month mortality prediction. METHODS: In a prospective analysis, 1,317 first-ever IS patients with HbA1c values were classified by first glycemia value (<155, 155-199, ≥200 mg/dl). Three-month mortality was analyzed by glycemia category in nondiabetics, diabetics with good previous glucose control (PGC) (HbA1c <7%), and diabetics with poor PGC (HbA1c ≥7.0%). RESULTS: Mortality at 3 months was 13.1%, with no differences (p = 0.339) between non-diabetes mellitus (DM) (12.3%), good PGC-DM (12.4%), and poor PGC-DM (15.6%) patients. The unadjusted relative risk of 3-month mortality for patients with glucose ≥200 mg/dl was 3.76 (95% CI 1.48-9.56) in non-DM, 6.10 (95% CI 1.76-21.09) in good PGC-DM, and 1.44 (95% CI 0.77-2.69) in poor PGC-DM. Glycemia cutoffs most highly correlated with mortality increased as PGC declined: 107 mg/dl in non-DM, 152 mg/dl in good PGC-DM, and 229 mg/dl in poor PGC-DM patients. Glycemia correlated with stroke severity in nondiabetics and diabetic patients with good PGC, but not in those with poor PGC. CONCLUSIONS: HbA1c determination combined with first measured glucose value is useful to stratify mortality risk in IS patients: hyperglycemia is a poor prognostic marker in non-DM and DM patients with good PGC; results are inconsistent in poor PGC-DM patients. Our data suggest the relationship between hyperglycemia and poor outcome reflects stress response rather than a deleterious effect of glucose.
dc.description.sponsorship This study was supported in part by Spain’s Ministry of Health (Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III FEDER, RD12/0042/0020 and RD12/0042/0061).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Karger
dc.rights © 2015 S. Karger AG, Basel http://dx.doi.org/10.1159/000440735/n/n‘This is the peer-reviewed but unedited manuscript version of the following article: Cerebrovasc Dis. 2015;40(5-6):244-50. doi: 10.1159/000440735. The final, published version is available at http://www.karger.com/?doi=10.1159/000440735.’
dc.subject.other Hemoglobina
dc.subject.other Glucosa
dc.subject.other Malalties cerebrovasculars
dc.title Glycated hemoglobin value combined with initial glucose levels for evaluating mortality risk in patients with ischemic stroke.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1159/000440735
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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