Higher HbA1c-Hemoglobin Ratio Was Associated With Poor Outcome in Endovascular Thrombectomy Patients.

Abstract

Background and objectives: Recent studies have identified the HbA1c-to-hemoglobin ratio (HHR) as a potential indicator for increased mortality from all causes and cardiovascular diseases. This investigation sought to determine whether HHR could serve as a prognostic marker for neurological function at 90 days in patients undergoing endovascular thrombectomy procedures.

Methodology: This study performed a retrospective evaluation of patients undergoing endovascular treatment (EVT) at Nanjing First Hospital from April 2022 to June 2024. The HHR was determined by dividing HbA1c levels by hemoglobin values. Poor clinical outcomes were characterized by modified Rankin Scale scores ranging from 3 to 6 at the 90-day follow-up. Multivariate logistic regression analysis was employed to examine the association between HHR values and posttreatment functional outcomes.

Results: The study enrolled 353 participants (average age of 70.5 years with a standard deviation of 12.2 years; 218 were male), of whom 181 (51.3%) showed adverse clinical results after 90 days. Multivariate regression analysis revealed that higher HHR levels upon hospital admission independently predicted worse functional recovery (adjusted OR: 10.484; 95% confidence interval: 4.581-23.990; p = 0.001). Additional investigation using restricted cubic spline methodology confirmed a nonlinear, dose-dependent relationship between HHR values and negative prognosis likelihood (nonlinearity p value = 0.001). When implemented in a predictive framework, continuous HHR measurements exhibited a strong discriminatory capability, achieving a receiver operating characteristic curve value of 0.760 (95% CI: 0.710-0.810).

Conclusion: Increased HHR levels demonstrate an independent correlation with poorer 90-day recovery rates among ischemic stroke patients undergoing endovascular thrombectomy. This evidence positions HHR as a potentially valuable indicator for clinical prognosis assessment in such cases.