Peer-reviewedCC BY-NCJournal of stroke
Five-Day Glycemic Patterns and 3-Month Functional Outcomes After Endovascular Thrombectomy.
28 affiliations
- 1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 2Bonghwa-Gun Public Health Center, Bonghwa, Korea.
- 3Clinical Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Neurology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
- 5Department of Neurology, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
- 6Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
- 7Department of Neurology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
- 8Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- 9Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
- 10Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
- 11Department of Neurology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.
- 12Department of Neurology, Dong-A University Hospital, College of Medicine, Dong-A University, Busan, Korea.
- 13Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
- 14Department of Neurology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea.
- 15Department of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea.
- 16Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.
- 17Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
- 18Department of Neurology, Korea University Anam Hospital, Korea University Medicine, Seoul, Korea.
- 19Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
- 20Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
- 21Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
- 22Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea.
- 23Department of Neurology, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea.
- 24Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea.
- 25Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
- 26Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- 27Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 28Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. [email protected].
Abstract
Background and purpose
Admission hyperglycemia is associated with poor outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke, but whether post-EVT glycemic pattern determines functional outcome remains unknown.Methods
A Retrospective Study for the Prediction of Clinical Outcomes in Acute Ischemic Stroke Patients with Thrombectomy study was a hybrid prospective-retrospective multicenter cohort study nested within the Rescue on Reperfusion Damage in Cerebral Infarction by Nelonemdaz trial (NCT05041010) across 24 tertiary stroke centers in South Korea. Patients with ≥80% measurements within 80-140 mg/dL and no value ≥200 mg/dL were classified as normoglycemic (Group 1); the remainder were classified by group-based trajectory modeling into persistently elevated (Group 2) and variable hyperglycemia (Group 3). The primary outcome was 3-month modified Rankin Scale (mRS) distribution.Results
Among 457 patients, 319 were included (mean age 73.6±12.2 years; 53.6% male): 97 (30.4%) in Group 1, 159 (49.8%) in Group 2, and 63 (19.7%) in Group 3. Groups 2 and 3 had more diabetes and higher hemoglobin A1c; stroke severity, Alberta Stroke Program Early Computed Tomography Scores, and reperfusion status were comparable. Both hyperglycemic groups had lower odds of a favorable mRS shift than Group 1 (adjusted common odds ratio [OR] 0.35, 95% confidence interval [CI] 0.20-0.61 and 0.49, 0.25-0.94). Functional independence (mRS 0-2) was achieved in 63.9% of Group 1 versus 36.5% and 38.1% in Groups 2 and 3 (adjusted OR 0.26, 95% CI 0.13-0.53 and 0.31, 0.13-0.73). No significant difference was observed between Groups 2 and 3.Conclusions
Five-day post-EVT hyperglycemic status was independently associated with worse 3-month functional outcomes beyond chronic glycemic burden, supporting re-evaluation of targeted glycemic interventions during this vulnerable window.
Related
- Impact of prehospital scene-to-door time on functional outcomes after endovascular thrombectomy: insights from a regional stroke network
- Apparent Diffusion Coefficient Composition and Tissue Heterogeneity as Predictors of Functional Outcomes After Endovascular Thrombectomy in Patients With Large Ischemic Core
- Functional outcomes and quality of life after endovascular thrombectomy in large and extensive infarcts (ASPECTS 0-5): a multicentre registry study.
- Association Between Hypoperfusion Intensity Ratio and Outcomes After Endovascular Thrombectomy in Posterior Circulation Stroke: A Retrospective Study
- Association of Estimated Arterial Stiffness with Collateral Status and Functional Outcome after Endovascular Thrombectomy: A Secondary Analysis of the OPTIMAL-BP Trial
BibTeX
@article{song2026fiveday,
title = {{Five-Day Glycemic Patterns and 3-Month Functional Outcomes After Endovascular Thrombectomy.}},
author = {Kwanju Song and Ji Sung Lee and Hyun Goo Kang and Seong Hwan Ahn and Tae-Jin Song and Dong-Ick Shin and Hee-Joon Bae and Chang Hun Kim and Sung Hyuk Heo and Jin Soo Lee and Jae-Kwan Cha and Yeong Bae Lee and Eung Gyu Kim and Man Seok Park and Hee-Kwon Park and Jinkwon Kim and Sungwook Yu and Heejung Mo and Sung Il Sohn and Jee Hyun Kwon and Jae Guk Kim and Young Seo Kim and Jay Chol Choi and Yang-Ha Hwang and Keun Hwa Jung and Soo-Kyoung Kim and Woo Keun Seo and Jung Hwa Seo and Joonsang Yoo and Jun Young Chang and Mooseok Park and Wookjin Yang and Bum Joon Kim and Sun U Kwon},
journal = {Journal of stroke},
year = {2026},
month = sep,
doi = {10.5853/jos.2026.03867},
url = {https://europepmc.org/article/MED/42894455},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Five-Day Glycemic Patterns and 3-Month Functional Outcomes After Endovascular Thrombectomy.
AU - Kwanju Song
AU - Ji Sung Lee
AU - Hyun Goo Kang
AU - Seong Hwan Ahn
AU - Tae-Jin Song
AU - Dong-Ick Shin
AU - Hee-Joon Bae
AU - Chang Hun Kim
AU - Sung Hyuk Heo
AU - Jin Soo Lee
AU - Jae-Kwan Cha
AU - Yeong Bae Lee
AU - Eung Gyu Kim
AU - Man Seok Park
AU - Hee-Kwon Park
AU - Jinkwon Kim
AU - Sungwook Yu
AU - Heejung Mo
AU - Sung Il Sohn
AU - Jee Hyun Kwon
AU - Jae Guk Kim
AU - Young Seo Kim
AU - Jay Chol Choi
AU - Yang-Ha Hwang
AU - Keun Hwa Jung
AU - Soo-Kyoung Kim
AU - Woo Keun Seo
AU - Jung Hwa Seo
AU - Joonsang Yoo
AU - Jun Young Chang
AU - Mooseok Park
AU - Wookjin Yang
AU - Bum Joon Kim
AU - Sun U Kwon
PY - 2026
DA - 2026/09/30
JO - Journal of stroke
DO - 10.5853/jos.2026.03867
UR - https://europepmc.org/article/MED/42894455
AB - Background and purpose Admission hyperglycemia is associated with poor outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke, but whether post-EVT glycemic pattern determines functional outcome remains unknown.Methods A Retrospective Study for the Prediction of Clinical Outcomes in Acute Ischemic Stroke Patients with Thrombectomy study was a hybrid prospective-retrospective multicenter cohort study nested within the Rescue on Reperfusion Damage in Cerebral Infarction by Nelonemdaz trial (NCT05041010) across 24 tertiary stroke centers in South Korea. Patients with ≥80% measurements within 80-140 mg/dL and no value ≥200 mg/dL were classified as normoglycemic (Group 1); the remainder were classified by group-based trajectory modeling into persistently elevated (Group 2) and variable hyperglycemia (Group 3). The primary outcome was 3-month modified Rankin Scale (mRS) distribution.Results Among 457 patients, 319 were included (mean age 73.6±12.2 years; 53.6% male): 97 (30.4%) in Group 1, 159 (49.8%) in Group 2, and 63 (19.7%) in Group 3. Groups 2 and 3 had more diabetes and higher hemoglobin A1c; stroke severity, Alberta Stroke Program Early Computed Tomography Scores, and reperfusion status were comparable. Both hyperglycemic groups had lower odds of a favorable mRS shift than Group 1 (adjusted common odds ratio [OR] 0.35, 95% confidence interval [CI] 0.20-0.61 and 0.49, 0.25-0.94). Functional independence (mRS 0-2) was achieved in 63.9% of Group 1 versus 36.5% and 38.1% in Groups 2 and 3 (adjusted OR 0.26, 95% CI 0.13-0.53 and 0.31, 0.13-0.73). No significant difference was observed between Groups 2 and 3.Conclusions Five-day post-EVT hyperglycemic status was independently associated with worse 3-month functional outcomes beyond chronic glycemic burden, supporting re-evaluation of targeted glycemic interventions during this vulnerable window.
SN - 2287-6391
SN - 2287-6405
ER -