Hyperglycemia Predicts Poor Thrombolysis Outcome in Ischemic Stroke
Issue 220

Hyperglycemia and intracranial hemorrhage are independent predictors of hyperacute clinical worsening in patients with acute ischemic stroke who are receiving thrombolytic therapy. At the University Hospitals of Cleveland in Ohio, Dr. Richard Leigh and colleagues studied 201 patients who were treated with thrombolytic therapy within 6 hours after the onset of symptoms of acute ischemic stroke.

To identify markers that might predict acute deterioration in such patients, the researchers compared baseline clinical variables, including National Institutes of Health Stroke Scale score, with the findings at 24 hours after treatment.

Overall, 13% of the patients deteriorated, 39% improved, and 48% had no change in their condition at 24 hours after thrombolytic therapy.

“Patients who deteriorated, compared to those who improved, were more likely to have complicating intracranial hemorrhage…absent recanalization…and higher blood glucose,” the investigators report.

On logistic regression analysis, the adjusted odds ratios for an increased risk of deterioration and death for a 50 mg/dL increase in blood glucose were 1.56 and 1.38, respectively, according to the article.

The authors point out that even if was recanalization was performed, blood glucose levels above 150 mg/dL correlated with a greater risk of poor short-term outcome.

“Although recanalization is the purpose of intra-arterial thrombolysis, its impact on clinical improvement may not be apparent without strict blood glucose control,” the authors conclude.

Stroke 2004;35:1903-1907.
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