Collateral status, hyperglycemia, and functional outcome after acute ischemic stroke.
Collateral status, hyperglycemia, and functional outcome after acute ischemic stroke.
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DOI：
10.1186/s12883-022-02943-4
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发表时间：
2022-11-04
期刊：
影响因子：
2.6
通讯作者：
Patel, Vishal N.
中科院分区：
文献类型：
--
作者：
Arteaga, Daniel F.;Ulep, Robin;Kumar, Kevin K.;Southerland, Andrew M.;Conaway, Mark R.;Faber, James;Wintermark, Max;Joyner, David;Sharashidze, Vera;Hirsch, Karen;Giurgiutiu, Dan-Victor;Hannawi, Yousef;Aziz, Yasmin;Shutter, Lori;Visweswaran, Anita;Williams, Alana;Williams, Kori;Gunter, Sonya;Haughey, Heather M.;Bruno, Askiel;Johnston, Karen C.;Patel, Vishal N.
当考虑到软脑膜侧支血流的影响时，关于急性缺血性卒中后高血糖和功能结局之间的相关性存在混合数据。我们试图确定侧支循环状态是否改变了参加卒中高胰岛素网络试验（SHINE）的大血管闭塞患者亚组中治疗组与功能结局之间的相关性。在这项事后分析中，我们分析了入组SHINE试验的前循环大血管闭塞患者，这些患者在葡萄糖控制治疗组分配前接受了CT血管造影成像。主要分析评估了侧支循环状态对治疗组和功能结局（由90天改良兰金量表评分定义）之间效应的影响程度。采用Logistic回归对数据进行建模，并对血栓切除术状态、年龄、脑梗死灌注后溶栓（TICI）评分、组织纤溶酶原激活剂（tPA）使用和基线国立卫生研究院卒中量表（NIHSS）评分进行调整。5家SHINE试验中心为该分析提供了数据。统计学显著性定义为p值< 0.05。在SHINE试验的1151例患者中，57例具有血管造影数据的患者被纳入该子分析，其中19例侧支循环不良，38例侧支循环良好。虽然侧支循环状态对血糖控制治疗组和功能结局之间的相关性没有影响（p = 0.855），但侧支循环良好的患者更可能具有有利的功能结局（p = 0.001，OR 5.02; 95% CI 1.37-16.0）。在一项使用SHINE试验中入组的具有血管造影数据的患者子集的事后分析中，侧支循环状态并未改变血糖控制治疗组与功能结局之间的相关性。然而，与之前的研究一致，在大血管闭塞性卒中患者中，良好的侧支循环状态与良好的结局之间存在显著相关性。ClinicalTrials.gov标识符是NCT 01369069。注册日期为2011年6月8日。在线版本包含补充材料，可通过10.1186/s12883-022-02943-4获得。
Mixed data exist regarding the association between hyperglycemia and functional outcome after acute ischemic stroke when accounting for the impact of leptomeningeal collateral flow. We sought to determine whether collateral status modifies the association between treatment group and functional outcome in a subset of patients with large vessel occlusion enrolled in the Stroke Hyperglycemia Insulin Network Effort (SHINE) trial. In this post-hoc analysis, we analyzed patients enrolled into the SHINE trial with anterior circulation large vessel occlusion who underwent imaging with CT angiography prior to glucose control treatment group assignment. The primary analysis assessed the degree to which collateral status modified the effect between treatment group and functional outcome as defined by the 90-day modified Rankin Scale score. Logistic regression was used to model the data, with adjustments made for thrombectomy status, age, post-perfusion thrombolysis in cerebral infarction (TICI) score, tissue plasminogen activator (tPA) use, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Five SHINE trial centers contributed data for this analysis. Statistical significance was defined as a p-value < 0.05. Among the 1151 patients in the SHINE trial, 57 with angiographic data were included in this sub-analysis, of whom 19 had poor collaterals and 38 had good collaterals. While collateral status had no effect (p = 0.855) on the association between glucose control treatment group and functional outcome, patients with good collaterals were more likely to have a favorable functional outcome (p = 0.001, OR 5.02; 95% CI 1.37–16.0). In a post-hoc analysis using a subset of patients with angiographic data enrolled in the SHINE trial, collateral status did not modify the association between glucose control treatment group and functional outcome. However, consistent with prior studies, there was a significant association between good collateral status and favorable outcome in patients with large vessel occlusion stroke. ClinicalTrials.gov Identifier is NCT01369069. Registration date is June 8, 2011. The online version contains supplementary material available at 10.1186/s12883-022-02943-4.
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影响因子：
6.3
作者：
Liebeskind, David S.;Cotsonis, George A.;Chimowitz, Marc I.
通讯作者：
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