Does Tight Glucose Control During the First 24 hours of Hospitalization Reduce Scintigraphic Infarct Size in STEMI Patients?

2020 ◽  
Author(s):  
Kamil Gulsen ◽  
Burak Ayca ◽  
Murat Baskurt ◽  
Baris Okcun ◽  
Murat Kazim Ersanli
Keyword(s):  
Infarct Size ◽  
Glucose Control ◽  
Tight Glucose Control

Abstract WP378: Insulin in the Management of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Christian D Cerecedo Lopez ◽  
Alejandra Cantu Aldana ◽  
Nirav J Patel ◽  
Mohammad A Aziz-Sultan ◽  
Kai U Frerichs ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Glycemic Control ◽  
Acute Ischemic Stroke ◽  
Glucose Control ◽  
Meta Analysis ◽  
Severe Hypoglycemia ◽  
Tight Glycemic Control ◽  
Tight Glucose Control ◽  
Random Effects Models

Background: The role of tight glycemic control in the management of acute ischemic stroke remains uncertain. Objective: Our goal is to evaluate the effects of tight glucose control with insulin therapy after acute ischemic stroke. Methods: We searched PubMed, CENTRAL, and EMBASE for randomized controlled trials (RCTs) that evaluated the effects of tight glycemic control (70 - 135 mg/dL) in acute ischemic stroke. Analysis was performed using fixed- and random-effects models. Outcomes were death, independence and modified Rankin Scale (mRS) score at ≥90 days follow-up, and symptomatic or severe hypoglycemia during treatment. Results: Twelve RCTs including 2,734 patients were included. When compared to conventional therapy or placebo, tight glycemic control was associated with similar rates of mortality at ≥90 days follow-up (pooled odds ratio [pOR], 0.99 [95% CI, 0.79 - 1.22], I 2 0%), independence at ≥90 days follow-up (pOR, 0.95 [0.79 - 1.14], I 2 0%) and mRS scores at ≥90 days follow-up (standardized mean difference, 0.014 [-0.15 - 0.17], I 2 0%). In contrast, tight glycemic control was associated with increased rates of symptomatic or severe hypoglycemia during treatment (pOR 5.2 [1.87 - 14.42], I 2 20%). Conclusion: Tight glucose control after acute ischemic stroke is not associated with improvements in mortality, independence or mRS score and leads to higher rates of symptomatic or severe hypoglycemia.

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