Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic Stroke

Five pretreatment variables (P300 mg/dL), predicted symptomatic intracerebral hemorrhage (ICH) in the National Institute of Neurological Disorders and Stroke rtPA trial. We retrospectively studied stroke patients treated 33% middle cerebral artery territory hypodensity]), were reviewed in 138 consec...

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Bibliographic Details
Published in:Stroke (1970) 1999, Vol.30 (1), p.34-39
Main Authors: DEMCHUK, A. M, MORGENSTERN, L. B, KRIEGER, D. W, CHI, T. L, HU, W, WEIN, T. H, HARDY, R. J, GROTTA, J. C, BUCHAN, A. M
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Biological and medical sciences
Blood Glucose
Blood. Blood coagulation. Reticuloendothelial system
Brain Ischemia - complications
Brain Ischemia - drug therapy
Brain Ischemia - metabolism
Cerebral Hemorrhage - chemically induced
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - metabolism
Cerebrovascular Disorders - blood
Cerebrovascular Disorders - complications
Cerebrovascular Disorders - drug therapy
Cohort Studies
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - metabolism
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - metabolism
Female
Humans
Hyperglycemia - complications
Hyperglycemia - metabolism
Male
Medical sciences
Pharmacology. Drug treatments
Plasminogen Activators - antagonists & inhibitors
Predictive Value of Tests
Regression Analysis
Retrospective Studies
Thrombolytic Therapy - adverse effects
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Summary:Five pretreatment variables (P300 mg/dL), predicted symptomatic intracerebral hemorrhage (ICH) in the National Institute of Neurological Disorders and Stroke rtPA trial. We retrospectively studied stroke patients treated 33% middle cerebral artery territory hypodensity]), were reviewed in 138 consecutive patients. Variables were evaluated by logistic regression as predictors of all hemorrhage (including hemorrhagic transformation) and symptomatic hemorrhage on follow-up CT scan. Variables significant at P11.1 mmol/L was associated with a 25% symptomatic hemorrhage rate. Baseline NIHSS (5-point increments) was an independent predictor of all hemorrhage only [OR, 12.42 (CI, 1.64 to 94.3), P=0.01]. Univariate analysis demonstrated a trend for nonsmoking as a predictor of all hemorrhage [OR, 0.45 (CI, 0.19 to 1. 08), P=0.07]. Diabetes was also an independent predictor of ICH when substituted for glucose in repeat analysis. Serum glucose and diabetes were predictors of ICH in rtPA-treated patients. This novel association requires confirmation in a larger cohort.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.30.1.34