HbA1c at admission linked to vascular risks in patients with ischemic stroke, diabetes

Blood sugar levels at admission were significantly linked to risk for composite vascular events among patients with ischemic stroke and diabetes, according to results published in Neurology.

“The purpose of the current study was to investigate and further delineate the association between HbA1c at admission and the subsequent risk of composite vascular events, including stroke, myocardial infarction (MI) and vascular death, in patients with acute ischemic stroke and [diabetes mellitus],” Jun Young Chang, MD, PhD, of the department of neurology at Asan Medical Center in South Korea, and colleagues wrote. “The influence of pre-stroke glucose control on cardiovascular events according to the ischemic stroke subtypes was also evaluated.”

Investigators used a retrospective cohort design and analyzed data of 18,567 patients with transient ischemic attack or acute ischemic stroke within 7 days of symptom onset and diabetes from the stroke registry of the Clinical Research Center for Stroke in Korea. They used the Fine-Gray model to estimate the correlation between HbA1c at admission and composite vascular events during 1-year follow-up. Using fractional polynomial and linear-quadratic models, they investigated the risk for composite vascular events based on ischemic stroke subtype.

A total of 1,437 patients developed composite vascular events during follow-up. Multivariable analysis with HbA1c as a categorical variable revealed significantly increased risk at a threshold of 6.8% to 7%. Patients whose fasting glucose at admission was less than 130 mg/dL had a particularly pronounced impact of HbA1c level at admission on the risk for composite vascular events. Small vessel occlusion subtype (6.6; 95% CI, 6.3-6.9), large artery atherosclerosis (7.3; 95% CI, 6.8-7.9) and the cardioembolic subtype (7.4; 95% CI, 6.3-8.5) had the lowest optimal ranges of HbA1c associated with a minimum risk for composite vascular events.

“Our findings highlight the importance of keeping a close eye on your blood sugar if you’re diabetic and have had a stroke,” study author Moon-Ku Han, MD, PhD, of Seoul National University College of Medicine in Korea, said in a press release.

Reference:

What are ideal blood sugar levels for preventing repeat strokes, heart attacks? https://www.sciencedaily.com/releases/2021/09/210929160134.htm#:~:text=%22But%20our%20results%20indicate%20that,an%20average%20age%20of%2070. Published Sept. 29, 2021. Accessed Oct. 1, 2021.