Hyperglycemia Is Associated With Computed Tomography Perfusion Core Volume Underestimation in Patients With Acute Ischemic Stroke With Large‐Vessel Occlusion

作者：Arash Niktabe, Juan Carlos Martínez-Gutiérrez, Sergio Salazar‐Marioni, Rania Abdelkhaleq, Juan Carlos Rodriguez Quintero, Jerome Jeevarajan, Muhammad Bilal Tariq, Ananya Iyyangar, Hussain Azeem, Anjan Nagesh Ballekere, Ngoc Mai Le, Louise D. McCullough, Sunil A. Sheth, Youngran Kim · 发表于：Stroke Vascular and Interventional Neurology · 年份：2024 · DOI：10.1161/svin.123.001278 · 被引用次数：5 · 研究领域：Acute Ischemic Stroke Management、Neurological and metabolic disorders、Cerebrovascular and Carotid Artery Diseases

Background Computed tomography perfusion (CTP) predictions of infarct core play an important role in the determination of treatment eligibility in large‐vessel occlusion acute ischemic stroke. Prior studies have demonstrated that blood glucose can affect cerebral blood flow. Here, we examine the influence of acute and chronic hyperglycemia on CTP estimations of infarct core. Methods From our prospectively collected multicenter observational cohort, we identified patients with large‐vessel occlusion acute ischemic stroke who underwent CTP with RAPID (IschemaView, Stanford, CA) postprocessing, followed by endovascular therapy with substantial reperfusion (Thrombolysis in Cerebral Infarction 2b–3) within 90 minutes, and final infarct volume determination by magnetic resonance imaging 48 to 72 hours posttreatment. Core volume overestimations and underestimations were defined as a difference of at least 20 mL between CTP‐RAPID predicted infarct core and Diffusion Weighted Imaging (DWI) final infarct volume. Primary outcome was the association of presentation glucose and hemoglobin A1c (HgbA1c) with underestimation of core volume and was measured using multivariable logistic regression adjusted for comorbidities and presentation characteristics. Secondary outcomes included frequency of overestimation of infarct core. Results Among 256 patients meeting inclusion criteria, median age was 67 (interquartile range [IQR], 57–77) years, 51.6% were women, and 132 (51.6%) and 93 (36.3%) had...