Glycosylated hemoglobin A1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke

doi:10.3877/cma.j.issn.2095-123X.2020.03.004

Abstract

Abstract:

Objective

To determine the predictive value of glycosylated hemoglobin A1 (HbA1c) on symptomatic intracerebral hemorrhage (sICH).

Methods

The patients treated with thrombolysis were included in Neurology Department of Jurong Hospital affiliated to Jiangsu University from May 2017 to May 2020. Baseline data was obtained at admission. According to the presence of sICH within 24 h, the patients were divided into non-bleeding group and bleeding group. The relationship between HbA1c and sICH and the prognosis of poor neurological function at 3 months (mRs>2 scores) was analyzed by multivariate Logistic regression model.

Results

A total of 142 patients were included, among which 26(18.3%) patients in the sICH group and 116(81.7%) patients in the non-sICH group. Logistic multivariate regression analysis showed that history of antithrombotic therapy, high HbA1c and admission National Institute of Health stroke scale (NIHSS) score were independent risk factors for sICH, and poor prognosis at 3 months was 38% (10/26) and 19% (22/116), respectively. In multivariate analysis blood glucose at admission, time from onset to thrombolysis, HbA1c, and baseline NIHSS score were independently associated with poor prognosis at 3 months.

Conclusion

HbA1c turns out to be an important predictor of sICH after thrombolysi and poor prognosis at 3 months.

Key words: Acute ischemic stroke, Hemoglobin A1c, Intravenous thrombolysis, Prognosis

Yi Wang, Yanhang Ying, Bing Liu, Xucai Chen. Glycosylated hemoglobin A1 predicts risk for symptomatic hemorrhage after thrombolysis for acute stroke[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(03): 144-147.

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References 16

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因素		非sICH组（n=116）	sICH组（n=26）	χ²/t值	P值
年龄（岁，Mean±SD）		65.50±6.99	73.20±7.90	0.617	0.033
性别[例（%）]
	女性	48（41.4）	9（34.6）
	男性	68（58.6）	17（65.4）	0.404	0.525
既往史[例（%）]
	高血压	63（54.3）	16（61.5）	0.450	0.503
	糖尿病史	35（30.2）	9（34.6）	0.196	0.658
	高血脂	28（24.1）	10（38.5）	2.223	0.136
	心房颤动	19（16.4）	7（26.9）	1.579	0.209
	冠心病	15（12.9）	8（30.8）	4.979	0.026
	吸烟	32（27.6）	8（30.8）	0.106	0.744
	既往卒中史	9（7.8）	5（19.2）	3.145	0.076
	抗栓史	20（17.2）	10（38.5）	5.740	0.017
	肾功能不全	5（4.3）	2（7.7）	0.518	0.472
ONT（min，Mean±SD）		170.80±36.59	207.60±29.87	0.280	0.024
HbA1c（%，Mean±SD）		6.31±0.76	7.28±0.73	0.859	0.001
入院血糖（mmol/L，Mean±SD）		11.75±3.16	15.33±4.03	0.225	0.040
收缩压（mmHg，Mean±SD）		163.60±7.28	164.30±5.23	0.170	0.808
舒张压（mmHg，Mean±SD）		88.50±6.52	89.40±5.42	0.615	0.741
入院NIHSS评分（分，Mean±SD）		10.90±3.07	15.00±5.06	0.156	0.042
3个月mRs>2分[例（%）]		22（19）	10（38.5）	4.625	0.032

因素		非sICH组（n=116）	sICH组（n=26）	χ²/t值	P值
年龄（岁，Mean±SD）		65.50±6.99	73.20±7.90	0.617	0.033
性别[例（%）]
	女性	48（41.4）	9（34.6）
	男性	68（58.6）	17（65.4）	0.404	0.525
既往史[例（%）]
	高血压	63（54.3）	16（61.5）	0.450	0.503
	糖尿病史	35（30.2）	9（34.6）	0.196	0.658
	高血脂	28（24.1）	10（38.5）	2.223	0.136
	心房颤动	19（16.4）	7（26.9）	1.579	0.209
	冠心病	15（12.9）	8（30.8）	4.979	0.026
	吸烟	32（27.6）	8（30.8）	0.106	0.744
	既往卒中史	9（7.8）	5（19.2）	3.145	0.076
	抗栓史	20（17.2）	10（38.5）	5.740	0.017
	肾功能不全	5（4.3）	2（7.7）	0.518	0.472
ONT（min，Mean±SD）		170.80±36.59	207.60±29.87	0.280	0.024
HbA1c（%，Mean±SD）		6.31±0.76	7.28±0.73	0.859	0.001
入院血糖（mmol/L，Mean±SD）		11.75±3.16	15.33±4.03	0.225	0.040
收缩压（mmHg，Mean±SD）		163.60±7.28	164.30±5.23	0.170	0.808
舒张压（mmHg，Mean±SD）		88.50±6.52	89.40±5.42	0.615	0.741
入院NIHSS评分（分，Mean±SD）		10.90±3.07	15.00±5.06	0.156	0.042
3个月mRs>2分[例（%）]		22（19）	10（38.5）	4.625	0.032

项目	因素	偏回归系数	SE	Wald值	OR值	95%CI	P值
	抗栓史	0.069	0.631	0.012	1.135	1.179~2.136	0.032
sICH	HbA1c	0.601	0.485	1.537	1.865	1.289~3.522	0.026
	入院NIHSS评分	1.209	0.970	1.776	3.568	1.211~5.598	0.023
	入院血糖	0.430	1.155	0.139	1.732	1.397~2.822	0.042
3个月不良预后	ONT	0.898	0.530	2.872	2.257	1.375~4.227	0.035
3个月不良预后	HbA1c	0.596	0.486	1.505	2.158	1.383~3.458	0.032
	入院NIHSS评分	1.210	0.906	1.781	3.125	1.272~7.912	0.026

项目	因素	偏回归系数	SE	Wald值	OR值	95%CI	P值
	抗栓史	0.069	0.631	0.012	1.135	1.179~2.136	0.032
sICH	HbA1c	0.601	0.485	1.537	1.865	1.289~3.522	0.026
	入院NIHSS评分	1.209	0.970	1.776	3.568	1.211~5.598	0.023
	入院血糖	0.430	1.155	0.139	1.732	1.397~2.822	0.042
3个月不良预后	ONT	0.898	0.530	2.872	2.257	1.375~4.227	0.035
3个月不良预后	HbA1c	0.596	0.486	1.505	2.158	1.383~3.458	0.032
	入院NIHSS评分	1.210	0.906	1.781	3.125	1.272~7.912	0.026

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