Higher Insulin Resistance Level is Associated with Worse Clinical Response in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis
TRANSLATIONAL STROKE RESEARCH, cilt.7, sa.3, ss.167-171, 2016 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 7 Sayı: 3
- Basım Tarihi: 2016
- Doi Numarası: 10.1007/s12975-016-0453-y
- Dergi Adı: TRANSLATIONAL STROKE RESEARCH
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.167-171
- Anahtar Kelimeler: Acute ischemic stroke, Recombinant tissue-type plasminogen activator (rt-PA), Insulin, Homeostasis model assessment insulin resistance (HOMA-IR), TISSUE-PLASMINOGEN ACTIVATOR, BRAIN-FUNCTION, IN-VIVO, HYPERGLYCEMIA, SENSITIVITY, GLUCOSE, TRIAL, RISK
- Eskişehir Osmangazi Üniversitesi Adresli: Evet
Özet
Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke. We investigated whether there is a relationship between insulin resistance and clinical findings and outcomes of acute ischemic stroke patients treated with intravenous thrombolysis. In our study, 180 acute ischemic stroke non-diabetic patients treated with intravenous recombinant tissue-type plasminogen activator (iv rt-PA) were evaluated for insulin resistance assessed by homeostasis model assessment insulin resistance (HOMA-IR). The threshold for HOMA-IR was determined as 2.7. Patients were grouped as HOMA-IR>2.7 and HOMA-IR <= 2.7. Clinical features at baseline, 24th hour, and 3rd month were examined. Computed tomography (CT) findings for hemorrhagic transformation were also assessed. Patients with HOMA-IR>2.7 had significantly higher National Institutes of Health Stroke Scale (NIHSS) scores at 24th hour (p=0.005) and higher modified Rankin Scale (mRS) scores at 3rd month (p=0.011). Logistic regression analysis displayed that the presence of HOMAIR>2.7 increases the likelihood of poor outcome 2.93 times (confidence interval [CI] 1.001-1.079) (p=0.003). There was no statistically significant difference between baseline clinical features, hemorrhagic transformation (p=1.000), and mortality (p=0.350) rates. Insulin resistance at higher levels seems to be associated with poor clinical courses and outcomes in patients who received iv rt-PA.