Abstract Details

Title Effect of HbA1c Level on Discharge Modified Rankin Scale Who Received rt-PA in Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 224

Objective

Background BACKGROUND: Hyperglycemia due to diabetes mellitus after acute stroke is seen commonly. Relationship between HbA1c levels, vessel recanalization with stroke outcomes have not been studied.

Design/Methods DESIGN/METHODS: Our study was a retrospective cross sectional analysis of all patients (n=137) presenting between January 2009 and July 2012 with acute ischemic stroke. All patients who received IV rt-PA had HbA1c and discharge mRS included. Patients were divided into two groups based on HbA1c : A) HbA1c less than 6.5 B) HbA1c more than equal to 6.5. Continuous and categorical data were presented as means±SD and percents (%), respectively. Analysis of variance was used to compare the difference of means between the two groups. Discharge status was dichotomized based on mRS of 2 or more. Multivariate models were created adjusting for age, gender, NIHSS, Hypertension (HTN), Diabetes Mellitus (DM), and Hyperlipidemia (HLD). All measurements were done using the SAS software (version 9.2).

Results RESULTS: Group A (n= 95, mean Hba1c 5.3) was composed of 48% female and 42% males with mean NIHSS at admission: 13±3; Group B (n= 42, mean Hba1c 7.1) had 59% females, 41% males with mean NIHSS at admission: 11±6. Significant association between NIHSS at admission and mRS at discharge was noted (OR 1.27, 95%CI, 1.13-1.30). An association between DM and mRS of 2 or more at discharge was also seen (OR 2.44, 95% CI, 1.02-5.89). Group A had higher NIHSS at presentation however at discharge both groups had similar mRS outcomes.

Conclusions CONCLUSIONS: Clinical outcomes quantified by discharge mRS in patients with ischemic strokes treated with rt-PA is indeed dependent on HbA1c levels. Patients suffering from ischemic strokes with well controlled diabetes will ultimately have better clinical outcomes.

Authors/Disclosures
Mohammed A. Hussain, MD PRESENTER	No disclosure on file
Haitham Dababneh, MD	No disclosure on file
Siddhart K. Mehta, MD	Dr. Mehta has nothing to disclose.
Punam Dass, MD (Mount Sinai)	Dr. Dass has nothing to disclose.
Javaad Ahmad, MD (Good Samaritan Hospital)	No disclosure on file
Mohammad Moussavi, MD	Dr. Moussavi has nothing to disclose.
Spozhmy Panezai, MD (JFK Medical Center)	Dr. Panezai has nothing to disclose.
Jawad F. Kirmani, MD	Dr. Kirmani has nothing to disclose.
Joshua Z. Willey, MD, FAAN (Columbia University)	Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Edwards Scientific. Dr. Willey has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for RECARDIO. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BrainQ. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of the American College of Cardiology. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Uptodate. The institution of Dr. Willey has received research support from NIH. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as a Review chapter author, MKSAP 16-20 with American College of Physicians.

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