Correlation between HbA1C and Infarct Volume in Acute Ischemic Stroke (original) (raw)
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Association between HbA1c and functional outcome of new onset ischemic stroke in Diabetic patients
Journal of Dhaka Medical College
Background: Abnormal glucose metabolism is an independent risk factor for poor outcome following acute ischemic stroke. Objective: To evaluate the association between high HbA1c level and poor functional outcome in new onset ischemic stroke patient with diabetes mellitus. Method: This Cross sectional study was carried out in the Department of Neurology, BSMMU, Dhaka, from February 2013 to September 2014 on 50 patients with first attack of ischemic stroke with DM. modified Rankin Scale (mRS) and HbA1c were measured on 14th day of the stroke. During this period other important relevant investigations were also recorded. Result: Majority of the patients (40.0%) were in age group 51-60 years. The mean age was 58.9 ± 9.6 years with a range from 30 to 75 years. Males were 52.0% and females were 48.0%. Male to female ratio was 1.08:1. It was observed that more than one third (36.0%) patients were current smoker, 9(18.0%) were former smoker and 23(46.0%) were non smoker. Majority of the 29(...
American Journal of Biomedical Science & Research , 2019
Abstract Background: Diabetes is metabolic disorder that lead to atherosclerosis which could lead to vascular accident like acute ischemic stroke. To formulate effective preventive measures, it’s important to understand the impact of glycemic status on the severity of acute ischemic stroke in adult type II diabetic patient.Aim of study: Study to analyze the role of HbA1c level on the severity of acute ischemic stroke in adult over 39-year diabetic type II Libyan patients.Patients and methods: This is case control study of 40 subjects with acute ischemic stroke and diabetes type II (case subjects) were categorized in to 2 sub-groups based on HbA1c level at time of admission with acute ischemic stroke, patients with diabetes and acute ischemic stroke with good glycemic control (<7HbA1c) and patient with acute ischemic stroke and diabetes with poor glycemic control (>7HbA1c). 40 acute ischemic stroke patients without diabetes as controls, the diagnosis of cerebral infarction was confirmed by brain - CT scan. Neurological impairment was evaluated using the National Institutes of Health Stroke Scale (NIHSS). All subjects have blood hemoglobin A1c (HbA1c) measured at admission.Result: Poor glycemic control group had statistically significant high HbA1c value (8.510±1.260) when compared to good glycemic control group (5.921±0.501) and non-diabetic (5.8±0.540). Stroke severity at admission were higher in patients with poor glycemic control than in those with good glycemic control (90% vs 46.33%) with good glycemic control.Conclusion: Glycemic control has significant association on severity of ischemic stroke patients with diabetes. Estimation of HbA1c level at the time of admission might be predictor of the severity of neurological impairment in patient with acute ischemic stroke and diabetes mellitus type II. Keywords: Hemoglobin A1c; Stroke; Diabetes mellitus; Brain – CT
Journal of Neurology and Neurophysiology, 2016
Background: Diabetes mellitus the metabolic disorder can interact with atherosclerosis in ischemic strokes to initiate activate and propagate vascular events. To formulate effective preventive measures, it is mandatory to understand the impact of the glycemic status on the severity and functional outcome of Acute Ischemic stroke in patients with diabetes. Purpose of the study: Study the effect of Glycemic status at admission on severity and outcome of Acute Ischemic stroke in patients with diabetes. Materials and methods: The study is a prospective, case-control, hospital based study done at Department of Neurology, Narayana medical college for a period of 1½ year. Results: 130 acute ischemic stroke patients were studied. 100 patients were cases with diabetes mellitus. Remaining 30 patients were controls without diabetes. Case were subcategorised to good glycemic control (HbA1c 7) 97.5% patients of poor glycemic control group has moderate to severe stroke severity >7 (NIHSS) at a...
Background: Diabetes is a well-known risk factor for acute ischemic stroke (AIS). Some recent studies point to hemoglobin A1c (HbA1c) may have prognostic value in nondiabetic and diabetic patients with ischemic stroke (IS). The aim of this study was to evaluate the prognostic value of HbA1c on mortality and morbidity in AIS patients with and without diabetic. Methods: In this prospective observational study, 150 diabetic and nondiabetic patients with AIS were evaluated for serum HbA1c level, hypertension (HTN), hyperlipidemia, and smoking in the first 24 hours of admission to determine their value to predict mortality and mortality at 30 and 90 days. Morbidity was estimated by the National Institutes of Health Stroke Scale (NIHSS) and follow-up visits were scheduled 30 and 90 days after admission. Results were analyzed with independent t-test and logistic regression analysis. Results: In this study, 73 patients (48.7%) were female and the rest were men. At 30 days, the diabetic pati...
BMJ, 2016
The role of glycated haemoglobin (HbA1c) in the prediction of ischaemic stroke in individuals without diabetes is underestimated. Aims: We performed a study to analyse the role of HbA1c in the risk prediction of ischaemic stroke in Pakistani population without diabetes. We further studied the difference between HbA1c values of individuals with diabetes and without diabetes with stroke. Settings and design: Single centre, case-control. Materials and methods: In phase I, a total of 233 patients without diabetes with ischaemic stroke and 245 as controls were enrolled. Association of HbA1c levels, lipid profiles and blood pressure recordings with ischaemic stroke was analysed. In phase II, comparison was done between diabetics and nondiabetics with stroke. Statistical analysis: Comparison of the mean variables was performed with Student's t-tests. Logistic regression analysis with ischaemic stroke as the dependent variable was performed for phase I. Results: In phase I, the ischaemic stroke group had significantly higher HbA1c levels (5.9±2.9% vs 5.5± 1.6%) compared with controls (p<0.05). Triglyceride cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and HbA1c were the significant determinants of stroke (p<0.05). In phase II, mean HbA1c values were significantly higher in the diabetes group (7.6±2.1 vs 6.1±2.3) (p<0.05) but other parameters were not statistically significantly different (p>0.05). Conclusions: Higher HbA1c indicated a significantly increased risk for ischaemic stroke. An HbA1c value above 5.6% (prediabetic range) predicted future risk of stroke and efforts to maintain glucose level within the normal range (≤5.6%) in individuals with high cardiovascular risk are important.
Annals of rehabilitation medicine, 2015
To elucidate the association between glycemic control status and clinical outcomes in patients with acute ischemic stroke limited to the deep branch of the middle cerebral artery (MCA). We evaluated 65 subjects with first-ever ischemic stroke of the deep branches of the MCA, which was confirmed by magnetic resonance angiography. All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c (low <7.0% or high ≥7.0%). Neurological impairment and functional status were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Korean version of Modified Barthel Index (K-MBI), Korean version of Mini-Mental State Examination (MMSE-K), and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) at admission and discharge. Body mass index, serum glucose, homocysteine and cholesterol levels were also measured at admission. The two groups did not show a...
ISCHEMIC STROKE; FREQUENCY OF RAISED HEMOGLOBIN A1c IN PATIENTS PRESENTING WITH ISCHEMIC STROKE
The Professional Medical Journal
… Background: Patients with acute ischemic stroke frequently test positive for hyperglycemia, which is associated with a poor clinical outcome. This association between poor glycemic control and an unfavorable prognosis is particularly evident in patients with persistent hyperglycemia, patients without a known history of diabetes mellitus (DM), and patients with cortical infarction. Objective: To determine the frequency of raised hemoglobin A1c in patients presenting with ischemic stroke. Material & Methods: Study design: Retrospective study.
Journal of Pharmaceutical Research International, 2021
Aim: To study the incidence of HbA1c elevation in patients with ischemic stroke whose blood glucose levels were normal within the last six months. Study Design: A cross-sectional study. Place and Duration: This cross-sectional study of the 96 patients with cerebral ischemic disease selected from the internal medicine department of Bilawal medical college Hospital Kotri, Sindh, Pakistan for one-year duration from August 2019 to August 2020. Methods: Crossectional study was conducted in the internal medicinal department of Bilawal Medical college Hospital, Kotri Sindh, Pakistan for the period of one year from August 2019 to August 2020. Total 96 study subjects were selected with cerebral ischemic disease, 62 were males and 34 were females. Many factors such as age more than 20 years, ischemic stroke and RBG (Random Blood Glucose) were also evaluated from each participant. SPSS 23.00 version was used for statistical analysis of research data. Results: 57.01 ± 13.4 years was the mean ag...
Prognostic value of hemoglobin A1c in nondiabetic and diabetic patients with acute ischemic stroke
Iranian journal of neurology, 2016
Background: Diabetes is a well-known risk factor for acute ischemic stroke (AIS). Some recent studies point to hemoglobin A1c (HbA1c) may have prognostic value in nondiabetic and diabetic patients with ischemic stroke (IS). The aim of this study was to evaluate the prognostic value of HbA1c on mortality and morbidity in AIS patients with and without diabetic. Methods: In this prospective observational study, 150 diabetic and nondiabetic patients with AIS were evaluated for serum HbA1c level, hypertension (HTN), hyperlipidemia, and smoking in the first 24 hours of admission to determine their value to predict mortality and mortality at 30 and 90 days. Morbidity was estimated by the National Institutes of Health Stroke Scale (NIHSS) and follow-up visits were scheduled 30 and 90 days after admission. Results were analyzed with independent t-test and logistic regression analysis. Results: In this study, 73 patients (48.7%) were female and the rest were men. At 30 days, the diabetic pati...
Is post-stroke hyperglycemia a marker of stroke severity and prognosis: A pilot study
Neurology …, 2007
Background: Various physiological parameters like blood pressure, temperature, blood sugar after onset of stroke have been proposed as possible marker of stroke prognosis. Objective: To study the glycaemic status after acute stroke and assess the role of glycaemic status along with other clinical parameters in influencing stroke outcome. Method: Forty-two confirmed stroke patients attending hospital within 6 hours of onset of stroke onset were included in the study. The time lag for hospitalization, blood pressure, blood sugar, HbA1c, stroke severity according to Toronto Scale, demographic factors, stroke onset type, type of stroke, past history of stroke, diabetes, and hypertension were recorded. The outcome was whether patient survived at the end of forth week. Results: Twenty-one percent of patients who were not known diabetic found to be hyperglycemic though their HBA1C level was normal. Eighty-nine percent of such patients died. This rate was significantly higher than patients known to be diabetic with raised sugar and HBA1c level (26% patients, 12% mortality). There was strong and significant association between stroke severity and poor outcome. Strong and significant association was also found between stroke severity and blood sugar level. Modeling of stroke outcome using decision tree analysis (QUEST) found stroke severity as most important and significant predictor especially for severe stroke cases. In mild and moderately severe stroke, high sugar level was found to be a predictor, though not statistically significant. Conclusion: This study suggests that stroke severity is the most important predictor of stroke outcome, with high sugar level as a marker of stroke severity.