Abstract Details

Title Association of Stress Hyperglycemia Ratio and Intracranial Hemorrhage Following Bridging Thrombolysis and Endovascular Treatment for Large Vessel Occlusion Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-003

Objective To assess the association between the stress hyperglycemia ratio (SHR) and the occurrence of parenchymal hemorrhage (PH) following bridging thrombolysis and endovascular treatment (EVT) in patients with large vessel occlusion stroke (LVOS).

Background Thrombolysis in hyperglycemic LVOS patients is associated with an increased rate of intracranial hemorrhage and poor outcome. The stress hyperglycemia ratio (SHR), which accounts for both acute and baseline glycemic states, may better reflect the body's stress response compared to a single glucose measurement.

Design/Methods SHR was defined as the ratio of admission glucose (mmol/l) to estimated average glucose derived from HbA1c (1.59 x HbA1c – 2.59). SHR values were dichotomized into < median and ≥ median for logistic regression analysis. Data were collected from 280 LVOS patients who received intravenous thrombolysis (IVT) and were referred for EVT between January 2020 and May 2024. Logistic regression was used to assess predictors of PH type 1 or 2 (composite endpoint variable).

Results Of the 280 LVOS patients, 99 patients received TPA and 181 received TNK. PH type 1 or 2 occurred in 12.9%. The median SHR was 1.04 (IQR 0.93 – 1.24) and did not differ between TPA and TNK cases (p=0.706). Univariable analysis showed that higher SHR, female sex, higher baseline NIHSS, lower platelet count, the number of thrombectomy passes, and stent-retriever use were associated with increased odds of developing PH type 1 or 2. Multivariable logistic regression revealed that both SHR (adjusted odds ratio [aOR] 2.762, 95% CI 1.244 – 6.131, p=0.013) and the number of thrombectomy passes were independent predictors of PH.

Conclusions A higher stress hyperglycemia ratio is independently associated with an increased risk of parenchymal hemorrhage in LVOS patients receiving bridging thrombolysis. These findings suggest that stress hyperglycemia may serve as a biomarker in predicting hemorrhagic complications in this patient population.

Authors/Disclosures
Kelsey Kline, BS PRESENTER	Miss Kline has nothing to disclose.
Tyler M. Bielinski	Mr. Bielinski has nothing to disclose.
Grant N. Badger	Mr. Badger has nothing to disclose.
Veronica Bohl	Ms. Bohl has nothing to disclose.
Prateeka Koul, MD	Dr. Koul has nothing to disclose.
Anthony Noto, MD (Geisinger Medical Center)	Dr. Noto has nothing to disclose.
Clemens M. Schirmer, MD, PhD	Dr. Schirmer has received personal compensation for serving as an employee of Geisinger. Dr. Schirmer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Balt. Dr. Schirmer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Schirmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stryker. Dr. Schirmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viz.ai. Dr. Schirmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Microvention. Dr. Schirmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Werfen. Dr. Schirmer has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Schirmer has stock in NTI. Dr. Schirmer has stock in REIST. The institution of Dr. Schirmer has received research support from NIH. The institution of Dr. Schirmer has received research support from Medtronic. The institution of Dr. Schirmer has received research support from Cerenovus. The institution of Dr. Schirmer has received research support from MIVI. The institution of Dr. Schirmer has received research support from Balt. The institution of Dr. Schirmer has received research support from Microvention. The institution of Dr. Schirmer has received research support from Stryker. The institution of Dr. Schirmer has received research support from Penumbra. The institution of Dr. Schirmer has received research support from NICO. The institution of Dr. Schirmer has received research support from Route 92.
Philipp Hendrix, MD, PhD	Dr. Hendrix has nothing to disclose.

��ɫ��

��ɫ��