Fasting blood glucose levels may predict prognosis of recanalization procedures like thrombectomy and thrombolysis: Study

A new retrospective study published in the Frontiers in Neurology highlighted the relationship between mean fasting blood glucose (MFBG) levels after the reperfusion of acute large vessel occlusion (ALVO) and patient prognosis. The analysis focused on fasting blood glucose as a significant indicator of patient outcomes following recanalization procedures such as mechanical thrombectomy and bridging thrombolysis.

The study explored the predictive factors influencing functional outcomes at 90 days post-reperfusion. The patients were divided into 2 groups based on their modified Rankin Scale (mRS) scores where one was a good prognosis group (mRS 0–2) and the other a poor prognosis group (mRS 3–6). Out of the total 2,056 participants across 3 major stroke centers in China, 1,370 patients were classified in the good prognosis group, while 686 fell into the poor prognosis category.

This research observed significant differences in age, preoperative mRS scores, diabetes history, and mean fasting blood glucose (MFBG) levels between the two groups (p < 0.001). The patients in the poor prognosis group expressed higher MFBG levels within 72 hours after recanalization. The data analysis demonstrated that these MFBG levels served as independent predictors for stroke outcomes, along with other factors such as age, preoperative functional status, and a history of diabetes.

Through both univariate and multivariate logistic regression analyses, MFBG stood out as a robust predictor of functional recovery which showed a higher predictive value when compared to other variables. The area under the receiver operating characteristic (ROC) curve for MFBG was 0.644 by indicating a noteworthy level of predictive accuracy. This metric surpassed the predictive capacities of age and preoperative mRS that emphasized the critical nature of post-recanalization blood glucose management.

The results underline the importance of closely monitoring fasting blood glucose levels in ALVO patients following vascular reperfusion. Elevated MFBG within the first 72 hours after recanalization may serve as an early warning for clinicians in guiding a more tailored post-procedural care and potentially improving long-term recovery outcomes.

Given the AUC value of 0.644 for MFBG, the clinicians may consider prioritizing glucose level monitoring as part of the early post-procedural evaluation to better stratify risk and implement timely interventions. While age, preoperative health, and diabetes history are important considerations, the monitoring and management of MFBG levels post-reperfusion emerge as pivotal elements in the pursuit of improved patient outcomes following ALVO recanalization.

Reference:

Luo, B., Xiang, Y., Meng, F., Wang, Y., Zhang, Z., Ren, H., & Ma, L. (2024). Impact of fasting blood glucose on prognosis after acute large vessel occlusion reperfusion: results from a multicenter analysis. In Frontiers in Neurology (Vol. 15). Frontiers Media SA. https://doi.org/10.3389/fneur.2024.1422851