Effect of HbA1c Level on Discharge Modified Rankin Scale Who Received rt-PA in Acute Ischemic Stroke (P01.224)

OBJECTIVE: Our aim was to examine the relationship between Hba1c and discharge modified rankin scale (mRS) in patients with acute ischemic stroke receiving IV rt-pa. BACKGROUND: Hyperglycemia due to diabetes mellitus after acute stroke is seen commonly. Relationship between HbA1c levels, vessel recanalization with stroke outcomes have not been studied. DESIGN/METHODS: Our study was a retrospective cross sectional analysis of all patients (n=137) presenting between January 2009 and July 2012 with acute ischemic stroke. All patients who received IV rt-PA had HbA1c and discharge mRS included. Patients were divided into two groups based on HbA1c : A) HbA1c less than 6.5 B) HbA1c more than equal to 6.5. Continuous and categorical data were presented as means±SD and percents (%), respectively. Analysis of variance was used to compare the difference of means between the two groups. Discharge status was dichotomized based on mRS of 2 or more. Multivariate models were created adjusting for age, gender, NIHSS, Hypertension (HTN), Diabetes Mellitus (DM), and Hyperlipidemia (HLD). All measurements were done using the SAS software (version 9.2). RESULTS: Group A (n= 95, mean Hba1c 5.3) was composed of 48% female and 42% males with mean NIHSS at admission: 13±3; Group B (n= 42, mean Hba1c 7.1) had 59% females, 41% males with mean NIHSS at admission: 11±6. Significant association between NIHSS at admission and mRS at discharge was noted (OR 1.27, 95%CI, 1.13-1.30). An association between DM and mRS of 2 or more at discharge was also seen (OR 2.44, 95% CI, 1.02-5.89). Group A had higher NIHSS at presentation however at discharge both groups had similar mRS outcomes. CONCLUSIONS: Clinical outcomes quantified by discharge mRS in patients with ischemic strokes treated with rt-PA is indeed dependent on HbA1c levels. Patients suffering from ischemic strokes with well controlled diabetes will ultimately have better clinical outcomes. Disclosure: Dr. Hussain has nothing to disclose. Dr. Dababneh has nothing to disclose. Dr. Mehta has nothing to disclose. Dr. Dass has nothing to disclose. Dr. Ahmad has nothing to disclose. Dr. Moussavi has nothing to disclose. Dr. Panezai has nothing to disclose. Dr. Kirmani has nothing to disclose.