Background: 

Hyperglycemia is common among patients presenting with acute ischemic stroke (AIS) and is associated with poor clinical outcomes. We studied the effects of intensive blood glucose control among AIS patients presenting with hyperglycemia treated with mechanical thrombectomy (MT).

Methods: 

We analyzed publicly available data from the Stroke Hyperglycemia Insulin Network Effort trial. In this nonpreplanned secondary analysis, we compared hyperglycemic AIS patients treated with MT who received intensive blood glucose control (80 to 130 mg/dL) with those who received standard blood glucose control (80 to 179 mg/dL). Outcomes included rates of favorable 90-day outcome (modified Rankin Scale score ≤2) and death.

Results: 

This analysis included 146 patients (74 in the intensive treatment group and 72 in the standard treatment group). Intensive blood glucose was not associated with higher rates of 90-day favorable outcomes (intensive 31.1% vs. standard 30.6%, P=1.0; odds ratio 1.025, 95% confidence interval 0.51 to 2.07) or a decrease in rates of death (intensive 20.3% vs. standard 22.2%, P=0.84; odds ratio 0.98, 95% confidence interval 0.40 to 1.97).

Conclusions: 

Intensive blood glucose control among AIS patients presenting with hyperglycemia and treated with MT was not associated with lower rates of death or higher rates of long-term favorable outcomes when compared with standard treatment.

中文翻译：

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强化血糖控制对接受机械血栓切除术的高血糖中风患者结局的影响：SHINE 试验的二次分析

背景： 

高血糖在急性缺血性卒中(AIS)患者中很常见，并且与不良临床结果相关。我们研究了机械血栓切除术 (MT) 治疗后出现高血糖的 AIS 患者强化血糖控制的效果。

方法： 

我们分析了中风高血糖胰岛素网络努力试验的公开数据。在这项非预先计划的次要分析中，我们比较了接受 MT 治疗并接受强化血糖控制（80 至 130 mg/dL）的高血糖 AIS 患者与接受标准血糖控制（80 至 179 mg/dL）的患者。结果包括良好的 90 天结果（改良 Rankin 量表评分≤2）和死亡率。

结果： 

该分析包括 146 名患者（强化治疗组 74 人，标准治疗组 72 人）。强化血糖与较高的 90 天有利结局发生率（强化 31.1% 与标准 30.6%，P = 1.0；优势比 1.025，95% 置信区间 0.51 至 2.07）或死亡率降低（强化20.3% 与标准 22.2%，P = 0.84；优势比 0.98，95% 置信区间 0.40 至 1.97）。

结论： 

与标准治疗相比，出现高血糖并接受 MT 治疗的 AIS 患者的强化血糖控制与较低的死亡率或较高的长期良好结局率无关。