{"title":"大血管闭塞患者血管内治疗后入院HbA1c水平与临床结局的关系：一项援救BT试验的二次分析","authors":"Fei Gao, Xiaolin Tan, Linyu Li, Chao Zhou, Changwei Guo, Jie Yang, Guojian Liu, Lilan Wang, Xiaolei Shi, Shihai Yang, Jinfu Ma, Xu Xu, Dahong Yang, Wenzhe Sun, Nizhen Yu, Shitao Fan, Rui Xu, Jiaxing Song, Wenjie Zi, Zhenying Shang","doi":"10.2147/CIA.S523638","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the association of HbA1c levels and outcomes in patients with large vessel occlusion (LVO) undergoing endovascular treatment (EVT).</p><p><strong>Methods: </strong>Patients with recorded HbA1c values were enrolled from The Endovascular Treatment With vs Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) trial. We defined the high HbA1c levels as a plasma level of HbA1c > 6.5%. The primary outcome was good outcome (defined as a modified Rankin Scale score (mRS) of 0-2) at 90 days, secondary outcomes included other clinical outcomes (excellent outcome, mRS 0-1) at 90 days, mortality at 90 days, symptomatic intracerebral hemorrhage (sICH) within 48h, and any intracerebral hemorrhage (ICH).</p><p><strong>Results: </strong>Among the 560 patients with HbA1c values, 133 (23.7%) patients were in the HbA1c > 6.5% group, and 427 (76.3%) patients were in the HbA1c ≤ 6.5% group. In multivariable analysis, the HbA1c > 6.5% group showed a significant negative association with good outcomes at 90 days (mRS 0-2; adjusted odds ratio [aOR], 0.57; 95% CI 0.37-0.88; <i>P</i> = 0.01), and the HbA1c > 6.5% group was significantly associated with increased mortality (aOR, 2.06; 95% CI 1.20-3.54; <i>P</i> = 0.009). There were no significant differences in the incidence of sICH between the two groups. Additionally, the subgroup analysis showed an interaction effect between high HbA1c levels and age.</p><p><strong>Conclusion: </strong>Our results demonstrated that elevated HbA1c levels were associated with poor clinical outcomes in LVO patients who underwent EVT.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"20 ","pages":"727-737"},"PeriodicalIF":3.7000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126986/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of Admission HbA1c Levels and Clinical Outcomes in Patients with Large Vessel Occlusion Following Endovascular Treatment: A Secondary Analysis of RESCUE BT Trial.\",\"authors\":\"Fei Gao, Xiaolin Tan, Linyu Li, Chao Zhou, Changwei Guo, Jie Yang, Guojian Liu, Lilan Wang, Xiaolei Shi, Shihai Yang, Jinfu Ma, Xu Xu, Dahong Yang, Wenzhe Sun, Nizhen Yu, Shitao Fan, Rui Xu, Jiaxing Song, Wenjie Zi, Zhenying Shang\",\"doi\":\"10.2147/CIA.S523638\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to analyze the association of HbA1c levels and outcomes in patients with large vessel occlusion (LVO) undergoing endovascular treatment (EVT).</p><p><strong>Methods: </strong>Patients with recorded HbA1c values were enrolled from The Endovascular Treatment With vs Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) trial. We defined the high HbA1c levels as a plasma level of HbA1c > 6.5%. The primary outcome was good outcome (defined as a modified Rankin Scale score (mRS) of 0-2) at 90 days, secondary outcomes included other clinical outcomes (excellent outcome, mRS 0-1) at 90 days, mortality at 90 days, symptomatic intracerebral hemorrhage (sICH) within 48h, and any intracerebral hemorrhage (ICH).</p><p><strong>Results: </strong>Among the 560 patients with HbA1c values, 133 (23.7%) patients were in the HbA1c > 6.5% group, and 427 (76.3%) patients were in the HbA1c ≤ 6.5% group. In multivariable analysis, the HbA1c > 6.5% group showed a significant negative association with good outcomes at 90 days (mRS 0-2; adjusted odds ratio [aOR], 0.57; 95% CI 0.37-0.88; <i>P</i> = 0.01), and the HbA1c > 6.5% group was significantly associated with increased mortality (aOR, 2.06; 95% CI 1.20-3.54; <i>P</i> = 0.009). There were no significant differences in the incidence of sICH between the two groups. Additionally, the subgroup analysis showed an interaction effect between high HbA1c levels and age.</p><p><strong>Conclusion: </strong>Our results demonstrated that elevated HbA1c levels were associated with poor clinical outcomes in LVO patients who underwent EVT.</p>\",\"PeriodicalId\":48841,\"journal\":{\"name\":\"Clinical Interventions in Aging\",\"volume\":\"20 \",\"pages\":\"727-737\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126986/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Interventions in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CIA.S523638\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Interventions in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CIA.S523638","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究旨在分析大血管闭塞（LVO）患者接受血管内治疗（EVT）时HbA1c水平与预后的关系。方法：记录HbA1c值的患者从大血管闭塞性卒中患者的血管内治疗与不使用替罗非班（RESCUE BT）试验中入组。我们将高HbA1c水平定义为血浆HbA1c水平达到6.5%。主要结局为90天的良好结局（定义为修改后的Rankin量表评分（mRS） 0-2），次要结局包括90天的其他临床结局（优异结局，mRS 0-1）， 90天的死亡率，48小时内的症状性脑出血（sICH），以及任何脑出血（ICH）。结果：560例HbA1c值患者中，HbA1c≥6.5%组133例（23.7%），HbA1c≤6.5%组427例（76.3%）。在多变量分析中，HbA1c > 6.5%组与90天的良好预后呈显著负相关(mRS 0-2；校正优势比[aOR]， 0.57；95% ci 0.37-0.88；P = 0.01)，且HbA1c≤6.5%组与死亡率升高显著相关(aOR, 2.06；95% ci 1.20-3.54；P = 0.009)。两组间sICH发生率无显著差异。此外，亚组分析显示高HbA1c水平与年龄之间存在相互作用。结论：我们的研究结果表明，HbA1c水平升高与接受EVT的LVO患者的不良临床结果相关。
Association of Admission HbA1c Levels and Clinical Outcomes in Patients with Large Vessel Occlusion Following Endovascular Treatment: A Secondary Analysis of RESCUE BT Trial.
Background: This study aimed to analyze the association of HbA1c levels and outcomes in patients with large vessel occlusion (LVO) undergoing endovascular treatment (EVT).
Methods: Patients with recorded HbA1c values were enrolled from The Endovascular Treatment With vs Without Tirofiban for Patients with Large Vessel Occlusion Stroke (RESCUE BT) trial. We defined the high HbA1c levels as a plasma level of HbA1c > 6.5%. The primary outcome was good outcome (defined as a modified Rankin Scale score (mRS) of 0-2) at 90 days, secondary outcomes included other clinical outcomes (excellent outcome, mRS 0-1) at 90 days, mortality at 90 days, symptomatic intracerebral hemorrhage (sICH) within 48h, and any intracerebral hemorrhage (ICH).
Results: Among the 560 patients with HbA1c values, 133 (23.7%) patients were in the HbA1c > 6.5% group, and 427 (76.3%) patients were in the HbA1c ≤ 6.5% group. In multivariable analysis, the HbA1c > 6.5% group showed a significant negative association with good outcomes at 90 days (mRS 0-2; adjusted odds ratio [aOR], 0.57; 95% CI 0.37-0.88; P = 0.01), and the HbA1c > 6.5% group was significantly associated with increased mortality (aOR, 2.06; 95% CI 1.20-3.54; P = 0.009). There were no significant differences in the incidence of sICH between the two groups. Additionally, the subgroup analysis showed an interaction effect between high HbA1c levels and age.
Conclusion: Our results demonstrated that elevated HbA1c levels were associated with poor clinical outcomes in LVO patients who underwent EVT.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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