Blood glucose to predict symptomatic intracranial hemorrhage after endovascular treatment of acute ischemic stroke with large infarct core: a prospective observational study

• Published in: Frontiers in neurology 2024-05, Vol.15, p.1367177
• Main Authors: Yang, Yujie, Yang, Lihui, Shi, Xiaolei, Ni, Xuan, Fan, Shitao, Xu, Xu, Ma, Jinfu, Yang, Shihai, Wang, Zhixi, Zi, Wenjie, Yang, Dahong, Hao, Yonggang
• Format: Article
• Language: English
• Subjects: acute ischemic stroke; endovascular treatment; glucose; large infarct core; Neurology; symptomatic intracranial hemorrhage
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2024.1367177

Symptomatic intracranial hemorrhage (sICH) is a serious complication of acute ischemic stroke (AIS) after endovascular treatment (EVT). Limited data exist regarding predictors and clinical implications of sICH after EVT, underscoring the significance of identifying risk factors to enhance prevention strategies. Therefore, the main objective of this study was to evaluate the incidence of sICH and identify its predictors after EVT in patients with large infarct core-AIS in the pre-circulation stage. Using data from the EVT for the Pre-circulation Large Infarct Core-AIS Study, we enrolled patients who were treated with EVT from the Prospective Multicenter Cohort Study of Early Treatment in Acute Stroke (MAGIC) registry. Baseline demographics, medical history, vascular risk factors, blood pressure, stroke severity, radiographic features, and EVT details were collected. The patients were classified into three groups: without intracranial hemorrhage (ICH), with asymptomatic intracranial hemorrhage (aICH), and sICH, based upon the occurrence of sICH. The main outcomes were the occurrence of sICH according to the Heidelberg Bleeding Classification and functional condition at 90 days. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to identify independent predictors of sICH after EVT. The study recruited a total of 490 patients, of whom 13.3% (  = 65) developed sICH. Patients with sICH had less favorable outcomes than those without intracranial hemorrhage (ICH) and those with aICH (13.8% vs. 43.5% vs. 32.2%, respectively;