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Master Thesis

Variabilité glycémique et pronostic fonctionnel post-AVC des patients traités par thrombolyse et thrombectomie

Abstract : Background and purpose: early glycemic variability (GV) in diabetic patients is a poor prognosis factor following cardiovascular events. However, its influence on the course of acute ischemic stroke (AIS) with large vessel occlusion remains unclear. We investigated the relationship between high GV during acute stroke and 3-months functional outcome among patients treated with combined intravenous thrombolysis and endovascular therapy for large vessel occlusion. Methods: a single-center retrospective analysis of AIS patients with proximal intracranial occlusion who underwent thrombolysis and mechanical thrombectomy between January 2015 and May 2017. Early GV was assessed using standard deviation (SD) of blood glucose levels for the first 24 hours. The main outcome was patients’ functional status at 3-months, as defined by the modified Rankin scale (mRS). Secondary outcomes were the evolution of the NIHSS from baseline to 24h and the occurrence of severe hemorrhagic transformation. Multivariate logistic regression analyzes were performed using 3 different models: GV, admission glycemia and mean glycemia. Results: among the 93 patients evaluated, 26 had early high GV (≥ 20.9 mg/dl). High GV was associated with poor functional outcome in its own model (OR 5.92; 95% CI [1.31-26.71]; p = 0.021) unlike admission glycemia and mean glycemia (OR 2.91; 95% CI [0.61-13.8]; p = 0.18 and OR 4.60; 95% CI [0.30-6.52]; p = 0.67, respectively). High GV was not associated with NIHSS at 24 hours or hemorrhagic transformation. Conclusion: acute high GV contributes to poorer functional outcome following AIS related to large vessel occlusion and should be considered as a new target in acute stroke management.
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https://dumas.ccsd.cnrs.fr/dumas-03363498
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Submitted on : Monday, October 4, 2021 - 9:17:27 AM
Last modification on : Saturday, October 23, 2021 - 3:24:39 AM

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  • HAL Id : dumas-03363498, version 1

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Julien Baudu. Variabilité glycémique et pronostic fonctionnel post-AVC des patients traités par thrombolyse et thrombectomie. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03363498⟩

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