ArticleVascular health and risk management2025
Fasting Blood Glucose on Prognosis After Acute Large Vessel Occlusion Reperfusion- A Multi-Center Study Based on Propensity Score Matching.
Article in Vascular health and risk management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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12 authors.
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Abstract
Purpose: To determine the impact of 24-hour post-reperfusion glycemic control on 90-day functional outcomes in acute large vessel occlusion (ALVO) patients after successful recanalization. Materials and Methods: This multi-center retrospective study analyzed 2056 ALVO patients (male: 1488; female: 568) from three cerebrovascular centers achieving successful reperfusion via mechanical thrombectomy with/without bridging thrombolysis. Using 1:1 propensity score matching (covariates: gender, age, Diabetes mellitus, hypertension, hyperlipidemia, cardiac disease, smoking status, glucose measurement timing, baseline NIHSS, and preoperative mRS), 194 matched pairs (mean age 63[IQR 55-71] years; male: 278) were stratified by 90-day modified Rankin Scale (mRS) outcomes into favorable (mRS 0-2) and poor prognosis (mRS 3-6) cohorts. Results: The poor prognosis cohort demonstrated significantly elevated mean fasting blood glucose (MFBG) levels (7.22 mmol/L [6.66-8.50] vs 6.86 mmol/L [6.28-7.58], P<0.001). Multivariable logistic regression adjusted for sex, age, vascular risk profile, and baseline NIHSS (adjusted OR=0.819, 95% CI 0.714-0.940, P=0.004) confirmed MFBG elevation as an independent risk factor for unfavorable outcomes. Conclusion: Sustained hyperglycemia during the initial 24-hour post-recanalization period independently predicts impaired 90-day functional recovery in ALVO patients. These findings highlight the imperative for standardized glucose monitoring protocols during the hyperacute post-thrombectomy phase, while optimal glycemic targets (<7.0 mmol/L vs individualized thresholds) and therapeutic windows for neuroprotection warrant validation through prospective multicenter RCTs.
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