Admission HbA1c Linked to Vascular Event Risk in Stroke Patients
Risk for composite vascular events increased at threshold of 6.8 to 7.0 percent for patients with ischemic stroke, diabetes
WEDNESDAY, Sept. 29, 2021 (HealthDay News) -- For patients with ischemic stroke and diabetes, admission hemoglobin A1c (HbA1c) is associated with the risks for composite vascular events, according to a study published online Sept. 29 in Neurology.
Jun Young Chang, M.D., Ph.D., from Asan Medical Center in Seoul, South Korea, and colleagues conducted a retrospective cohort study to examine the association between admission HbA1c and the subsequent risk for composite vascular events during a one-year follow-up in patients with acute ischemic stroke and diabetes.
The researchers found that 1,437 of the 18,567 patients developed composite vascular events during follow-up. Using HbA1c as a categorical variable, significantly increased risk was seen at a threshold of 6.8 to 7.0 percent in a multivariable analysis. Among those in whom fasting glucose at admission was ≤130 mg/dL, the influence of admission HbA1c level on the risk for composite vascular events was particularly pronounced. For composite vascular events, the optimal ranges of HbA1c associated with minimum cardiovascular risk were lowest for small vessel occlusion versus large artery atherosclerosis and cardioembolism (6.6, 7.3, and 7.4 percent, respectively).
"We know that having diabetes may be associated with an increased risk of having a first stroke," a coauthor said in a statement. "But our results indicate that there is an optimal blood sugar level that may start to minimize the risk of having another stroke, a heart attack, or other vascular problems, and it's right in the 6.8 to 7.0 percent range."