Abstract T P6: Is HbA1c a Predictor of Outcome in Ischemic Stroke Patients Who Undergo Intra-Arterial Treatment?

Abstract

Objective: Elevated blood glucose levels adversely affect the outcome of patients with acute ischemic stroke (AIS). We sought to study the predictive value of admission hemoglobin A1c (HbA1c) in AIS patients’ outcomes following intra-arterial stroke treatment (IAT). METHODS: We reviewed records of AIS patients who underwent IAT at our center from July 2012 - July 2013. The following data were collected and analyzed: patients’ demographics, baseline characteristics, treatment times and methods, rate of symptomatic and asymptomatic intracerebral hemorrhage, and favorable clinical outcome defined as modified Rankin score (mRS) ≤ 2 at 90 days or at last observation for patients treated within the last 90 days. HbA1c level was checked as part of routine stroke admission orders on all patients. RESULTS: Seventy consecutive patients who underwent IAT were identified. There were 42 (60%) females with mean cohort age of 64.4. The median ASPECT score was 9 (IQR 8-9) and baseline median National Institute of Health Stroke Scale Score was 18 (IQR 14-21). Overall 33 (47.1%) patients had favorable outcome. There were 15/70 (21.4%) asymptomatic and 2/70 (2.8%) symptomatic hemorrhages following IAT. Patients who developed hemorrhagic complications (17/70, 24%) following IAT had higher mean HbA1c levels (6.5 vs 5.9), however this finding was not statistically significant (ttest, p=0.09). Patients with favorable outcomes had lower mean admission HbA1c 5.9 (95% CI 5.6-6.2) versus 6.4 (95% CI 5.9-6.8). This finding was statistically significant (t-test, p 0.04). Multivariate logistic regression model identified low age (OR 0.93, 95%CI 0.88-0.99, p=0.03) as the only predictor of favorable outcome. CONCLUSION: Our study results indicate that admission HbA1c is a predictor of outcome in patients undergoing IAT for AIS. The value of this finding should be explored in a larger cohort.