Neurology: 1-year follow-up: the correlation between pre-stroke blood glucose control and vascular events

Diabetes mellitus (DM) increases the risk of first stroke by 1.
5 to 4.
0 times and increases the risk of recurring stroke by 2.
1 to 5.
6 times
.

Poor blood sugar control is associated with vascular events such as increased risk of atherosclerosis, increased carotid intima-media thickness, coronary heart disease, and atrial fibrillation

Current guidelines for diabetic stroke blood vessels recommend maintaining the target level of glycosylated hemoglobin (HbA1c) below 7.

The higher the HbA1c level, the higher the risk of first stroke

Recently, a study published in Neurology investigated the relationship between the risk of glycosylated hemoglobin (HbA1c) and subsequent complex vascular events (including stroke, myocardial infarction (MI), and vascular death) in patients with acute ischemic stroke and DM on admission .
According to the subtype of ischemic stroke, the impact of pre-stroke blood glucose control on cardiovascular events was evaluated
.

Recently, a study published in Neurology investigated the relationship between the risk of glycosylated hemoglobin (HbA1c) and subsequent complex vascular events (including stroke, myocardial infarction (MI), and vascular death) in patients with acute ischemic stroke and DM on admission .
According to the subtype of ischemic stroke, the impact of pre-stroke blood glucose control on cardiovascular events was evaluated
.

Myocardial infarction

Using the stroke registration of the Korean Stroke Clinical Research Center, patients with transient ischemic attack or acute ischemic stroke and diabetes within 7 days were included in the retrospective cohort design
.

The Fine-Gray model was used to evaluate the relationship between hospital admission HbA1c and complex vascular events including stroke, myocardial infarction (MI), and vascular death

• Of the 18,567 patients, 1,437 had a compound vascular event during the follow-up period
  .
  
• Multivariate analysis with glycosylated hemoglobin (HbA1c) as the categorical variable showed that within the threshold range of 6.
  8%-7.
  0%, the risk increased significantly
  .
  
• In patients with fasting blood glucose ≤130 mg/dL at admission, the level of glycosylated hemoglobin at admission has a particularly significant impact on the risk of complex vascular events
  .
  
• Compared with large artery atherosclerosis (7.
  3[95%CI, 6.
  8-7.
  9]) or cardioembolism subtype (7.
  4[95%CI, 6.
  3-8.
  5]), small vessel occlusion subtype has the lowest optimal range of HbA1c ( 6.
  6, [95% confidence interval, 6.
  3-6.
  9])
  .
  

Of the 18,567 patients, 1,437 had a compound vascular event during the follow-up period
.

Multivariate analysis with glycosylated hemoglobin (HbA1c) as the categorical variable showed that within the threshold range of 6.
8%-7.
0%, the risk increased significantly
.

In patients with fasting blood glucose ≤130 mg/dL at admission, the level of glycosylated hemoglobin at admission has a particularly significant impact on the risk of complex vascular events
.

Compared with large artery atherosclerosis (7.
3[95%CI, 6.
8-7.
9]) or cardioembolism subtype (7.
4[95%CI, 6.
3-8.
5]), small vessel occlusion subtype has the lowest optimal range of HbA1c ( 6.
6, [95% confidence interval, 6.
3-6.
9])
.

     In patients with ischemic stroke and DM, the risk of complex vascular events is significantly related to the admission of glycosylated hemoglobin (HbA1c)
.

The optimal hospital admission range for HbA1c is less than 6.

In patients with ischemic stroke and DM, the risk of complex vascular events is significantly related to the admission of glycosylated hemoglobin (HbA1c)

Literature source: https://n.
neurology.
org/content/early/2021/09/29/WNL.
0000000000012729.
long Literature source: https://n.
neurology.
org/content/early/2021/09/29 /WNL.
0000000000012729.
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