Abstract Details

Title Glycemic Gap vs Stress Hyperglycemic Ratio: A Comparative Assessment of Their Predictive Roles of Leptomeningeal Collateral Circulation and Clinical Outcomes in Acute Ischemic Large Vessel Occlusion.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-011

Objective To investigate how glycemic gap (GG) and stress hyperglycemic ratio (SHR) correlate to leptomeningeal collateral circulation (LMC) and 90-day mRS in acute ischemic stroke (AIS) patients with a large vessel occlusion (LVO).

Background Stress hyperglycemia (SHG) has been associated with poor LMC, larger infarct volume, and worse stroke outcomes, especially in patients with LVO. There are multiple formulas to estimate SHG, and currently, the direct correlation between these formulas and collateral status is unknown.

Design/Methods In this retrospective single-center study, we chart-reviewed patients admitted with AIS, who had anterior circulation LVO. Admission glucose levels were used to calculate two glycemic ratios: the GG, defined as Admission Blood Glucose (mg/dL) − (28.7 × HbA1c − 46.7); and the SHR, calculated as Admission Blood Glucose / [(28.7 × HbA1c) − 46.7]. CTA collaterals were classified using the Regenhardt et al. Patients were categorized into three groups—malignant, intermediate, and symmetric—based on their CTA collateral scores. 90-day mRS was dichotomized into good (≤2) and poor (2-6). Univariable regression analyses were performed first, only significant variables were fitted into the final multivariable regression models.

Results A total of 267 patients with LVO ischemic stroke was included in the study, with 54.3% male and 45.7% female. Regression analysis revealed that higher SHR and GG values were correlating with worse CTA collateral scores (P <0.01). Higher SHG values were significantly associated with poor 90-days mRS (P <0.01, OR= 6.6 [1.8-24]), but GG had nonsignificant association (P <0.07, OR= 1.0 [0.9-1.1])

Conclusions

There is a significant association between higher GG and SHR with poor LMC in patients with LVO. Nevertheless, SHG seems to have a stronger, and more significant association with 90-days mRS.

Authors/Disclosures
Sai Kumar Reddy Pasya, MD, MBBS PRESENTER	Dr. Pasya has nothing to disclose.
Emanuele Camerucci, MD (Kansas University Medical Center)	Dr. Camerucci has nothing to disclose.
Chelsey M. Schartz	Ms. Schartz has nothing to disclose.
Dina M. Al-Nuaimi, MD	Miss Al-Nuaimi has nothing to disclose.
Hussein Alsadi (University of Kansas Medical Center)	Hussein Alsadi has nothing to disclose.
Prasanna Venkatesan Eswaradass, MD (University of Kansas Health System)	Dr. Eswaradass has nothing to disclose.

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