Effect of glucose level on hemorrhagic conversion, in patiens with intravenous thrombolysis and endovascular treatment

초록

Abstract Title* Effect of glucose level on hemorrhagic conversion, in patiens with intravenous thrombolysis and endovascular treatment Introduction* Elevated blood glucose level(BGL) and the history of diabetes are known to be related to hemorrhagic conversion after reperfusion therapy. However, the effect of BGL on hemorrhagic conversion, according to the combined intravenous thrombolysis and endovascular treatment remains unclear. We investigated the relationship between BGL and hemorrhagic conversion after endovascular treatment according to intravenous thrombolysis. Methods* A consecutive 211 patients with occlusion of major cerebral artery and successful recanalization (TICI 2b or TICI 3) from three centers were included for the analysis between January 2013 and May 2017. The information on BGL and other clinical findings was reviewed retrospectively. We defined major hemorrhagic conversion as a parenchymal hematoma type 2 (PH2). Results* Among the included patients (age, 67.2; and Men. 56.9%), 23 patients developed major hemorrhagic conversion over the first 24 hours after successful recanalization. Univariate analysis showed that old age, low hemoglobin, low platelet count, low LDL and decreased eGFR were associated with hemorrhagic conversion. Among the total patients enrolled, fasting glucose level was associated with hemorrhagic conversion (P=0.04) and BGL on ER arrival had the tendency to increased hemorrhagic conversion(P=0.09). Among the patients with combined therapy including intravenous thrombolysis, hemorrhagic conversion had the tendency to the high fasting glucose level(P=0.08) evaluated after intervention, although initial BGL was not related. However, among the patients with mechanical thrombectomy only, the fasting BGL checked after intervention was not associated with hemorrhagic conversion. Conclusions* Our results suggested that the patients with comnbined theraphy seems to have the more closer association between hemorrhagic conversion