Evidence map›Paper›PMID 33140258›Full record

ReviewTranslational stroke research2021

Diabetes Mellitus/Poststroke Hyperglycemia: a Detrimental Factor for tPA Thrombolytic Stroke Therapy.

Yinghua Jiang, Ning Liu, Jinrui Han, Yadan Li, Pierce Spencer, Samuel J Vodovoz, Ming-Ming Ning, Gregory Bix, Prasad V G Katakam, Aaron S Dumont and 1 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Translational stroke research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Yinghua JiangClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA. yjiang11@tulane.edu.
Ning LiuClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Jinrui HanClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Yadan LiClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Pierce SpencerClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Samuel J VodovozClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Ming-Ming NingNeuroprotection Research Laboratory, Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02129, USA.
Gregory BixClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Prasad V G KatakamDepartment of Pharmacology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Aaron S DumontClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA.
Xiaoying WangClinical Neuroscience Research Center, Departments of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA, 70122, USA. xwang51@tulane.edu.
Tulane University · USMassachusetts General Hospital · US

Funding

Proteomic Profiling of Patent Foramen Ovale Related Neurovascular InjuryR01NS067139 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI NING, MINGMING · 2010 to 2023
$3.7M
Recombinant FGF21 as a novel approach for treating ischemic stroke in type 2 diabetesR01NS099539 · NINDS · TULANE UNIVERSITY OF LOUISIANA · PI WANG, XIAOYING · 2016 to 2020
$1.8M
Endothelial Expression of Neuronal Nitric Oxide SynthaseR01NS094834 · NINDS · TULANE UNIVERSITY OF LOUISIANA · PI KATAKAM, PRASAD V · 2016 to 2019
$1.3M
NINDS NIH HHS R01 NS094834NINDS NIH HHS R01 NS099539
6 · The paper itself

Abstract

Intravenous administration of tissue-type plasminogen activator (IV tPA) therapy has long been considered a mainstay in ischemic stroke management. However, patients respond to IV tPA therapy unequally with some subsets of patients having worsened outcomes after treatment. In particular, diabetes mellitus (DM) is recognized as a clinically important vascular comorbidity that leads to lower recanalization rates and increased risks of hemorrhagic transformation (HT). In this short-review, we summarize the recent advances in understanding of the underlying mechanisms involved in post-IV tPA worsening of outcome in diabetic stroke. Potential pathologic factors that are related to the suboptimal tPA recanalization in diabetic stroke include higher plasma plasminogen activator inhibitor (PAI)-1 level, diabetic atherogenic vascular damage, glycation of the tPA receptor annexin A2, and alterations in fibrin clot density. While factors contributing to the exacerbation of HT in diabetic stroke include hyperglycemia, vascular oxidative stress, and inflammation, tPA neurovascular toxicity and imbalance in extracellular proteolysis are discussed. Besides, impaired collaterals in DM also compromise the efficacy of IV tPA therapy. Additionally, several tPA combination approaches developed from experimental studies that may help to optimize IV tPA therapy are also briefly summarized. In summary, more research efforts are needed to improve the safety and efficacy of IV tPA therapy in ischemic stroke patients with DM/poststroke hyperglycemia.

Indexed as

Diabetes MellitusHyperglycemiaStrokeFibrinolytic AgentsHumansThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorDiabetes mellitusHyperglycemiaIntracerebral hemorrhageIschemic strokeRecanalization rateTissue-type plasminogen activator

Identifiers

PMID33140258
OpenAlexW3095280622

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.