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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
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.relation.ispartof Cerebrovascular Diseases. 2015;40(5-6):244-50
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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