Low Levels of Glycemia within the First 48 Hours after Mechanical Thrombectomy for Acute Ischemic Stroke May be Associated with Better Clinical Outcome

Šaňák, Daniel; Černík, David; Divišová, Petra; Köcher, Martin; Cihlář, Filip; Zapletalová, Jana; Dorňák, Tomáš; Ospalík, Dušan; Černá, Marie; Janoušová, Petra; Král, Michal; Veverka, Tomáš; Prasil, Vojtech; Franc, David; Kaňovský, Petr

doi:10.1016/j.jstrokecerebrovasdis.2019.104621

Cited by 5 publications

(1 citation statement)

References 31 publications

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“…Another recent study has shown, that a high glycemic variability in AIS patients contributed to poorer outcome after EVT [ 21 ]. Furthermore, low levels of glycemia within the first 48 h after EVT may be associated with better three-month outcome [ 22 ]. Results from the recent studies showed the association between admission glycemia and functional outcome after MT in diabetic patients [ 25 ], and also in the patients with admission NIHSS ≥ 10 and MCA occlusion [ 26 ], specifically if they presented with clinical-ASPECT mismatch and achieved early recanalization (TICI 2b-3) [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Havlíček,

Šaňák,

Černík

et al. 2024

Cardiovasc Intervent Radiol

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Purpose Endovascular treatment (EVT) of tandem lesion (TL) in anterior circulation (AC) acute ischemic stroke (AIS) represents still a clinical challenge. We aimed to evaluate selected factors related to EVT and assess other possible predictors of good clinical outcome besides the generally known ones. Methods AIS patients with TL in AC treated with EVT were enrolled in the multicenter retrospective ASCENT study. A good three-month clinical outcome was scored as 0–2 points in modified Rankin Scale (mRS) and achieved recanalization using the TICI scale. Symptomatic intracerebral hemorrhage (SICH) was assessed using the SITS-MOST criteria. Logistic regression analysis was used for the assessment of possible predictors of mRS 0–2 with adjustment for potential confounders. Results In total, 300 (68.7% males, mean age 67.3 ± 10.2 years) patients with median of admission NIHSS 17 were analyzed. Recanalization (TICI 2b-3) was achieved in 290 (96.7%) patients and 176 (58.7%) had mRS 0–2. Besides the age, admission NIHSS and SICH, admission glycemia (p = 0.005, OR: 0.884) the stent patency within the first 30 days after EVT (p = 0.0003, OR: 0.219), dual antiplatelet therapy (DAPT) started within 12 h after EVT (p < 0.0001, OR: 5.006) and statin therapy started within 24 h after stenting (p < 0.0001, OR: 5.558) were found as other predictors. Conclusion Admission glycemia, start of DAPT within 12 h and statin therapy within 24 h after EVT, and stent patency within the first 30 days after EVT were found as other predictors of good three-month clinical outcome in AIS patients treated with EVT for TL. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Havlíček,

Šaňák,

Černík

et al. 2024

Cardiovasc Intervent Radiol

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Ischemic stroke and reperfusion therapies in diabetic patients

et al. 2022

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Neutrophil–lymphocyte ratio in acute ischemic stroke: Immunopathology, management, and prognosis

2021

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There is an ongoing need for accurate prognostic biomarkers in the milieu of acute ischemic stroke (AIS) receiving reperfusion therapy. Neutrophil–lymphocyte ratio (NLR) has been implicated in emergency medicine and acute stroke setting as an important biomarker in the prognosis of patients. However, there are ongoing questions around its accuracy and translation into clinical practice given suboptimal sensitivity and specificity results, as well as varying thresholds and lack of clarity around which NLR time points are most clinically indicative. This article provides a comprehensive overview of the role of NLR in AIS patients receiving reperfusion therapy and perspectives on areas of future research. NLR may be an important biomarker in risk stratifying patients in AIS to identify and select those who are more likely to benefit from reperfusion therapy. Appropriate clinical decision‐making tools and models are required to harness the predictive value of NLR, which could be useful in identifying and monitoring high‐risk patients to guide early treatment and achieve improved outcomes. Our understanding of the role of NLR in the immunopathogenesis of AIS is also suboptimal, which hinders the ability to translate this into clinical practice.

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Low Levels of Glycemia within the First 48 Hours after Mechanical Thrombectomy for Acute Ischemic Stroke May be Associated with Better Clinical Outcome

Cited by 5 publications

References 31 publications

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Predictors of Good Clinical Outcome After Endovascular Treatment for Acute Ischemic Stroke due to Tandem Lesion in Anterior Circulation: Results from the ASCENT Study

Ischemic stroke and reperfusion therapies in diabetic patients

Neutrophil–lymphocyte ratio in acute ischemic stroke: Immunopathology, management, and prognosis

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