title: Higher fasting glucose next day after intravenous thrombolysis is independently associated with poor outcome in acute ischemic stroke.
abstract: BACKGROUND
  We aimed to test the outcome-predictive power of routine fasting glucose (FG) obtained at second day after onset in intravenous thrombolysis (IVT) acute ischemic stroke (AIS) patients.
  
  
  METHODS
  We identified AIS patients presenting to our institution between December 2011 and July 2013 within 4.5 hours of onset, who received admission glucose (AG) before IVT, FG, and glycated hemoglobin (HbA1c) the second day after admission, from our prospectively recorded stroke database. Multivariate logistic regression was used to assess the association of FG and 90-day modified Rankin Scale (mRS).
  
  
  RESULTS
  Between December 2011 and July 2013, a total of 166 AIS patients received intravenous plasminogen activator. Of those, 119 patients who have AG before IVT, FG, and HbA1c the second day were included in the study. FG independently predicted 90-day clinical unfavorable outcome (mRS, 3-6 with an odds ratio of 1.576; 95% confidence interval [CI], 1.053-2.358; P = .027). This association was not significant in AG (P = .714), HbA1c (P = .655), and history of diabetes (P = .547). In receiver operating characteristic analysis, increased FG was associated with 90-day mRS (3-6) with an area under curve of .72, (95% CI, .65-.9; P = .001).
  
  
  CONCLUSIONS
  FG is a powerful predictor associated with the outcome in IVT-treated AIS patients independent of AG and HbA1c.
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Cao
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Ling
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Lumeng
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: dongqiang2222@gmail.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002545:Brain Ischemia / Q000188:drug therapy*; D005215:Fasting / Q000378:metabolism; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D017211:Treatment Failure
chemical_list: D001786:Blood Glucose; D005343:Fibrinolytic Agents; D006442:Glycated Hemoglobin; D010959:Tissue Plasminogen Activator
keywords: Admission glucose; acute ischemic stroke; fasting glucose; thrombolysis