The Relationship between Acute Stress Hyperglycemia and Infarct Volume in Ischemic Stroke (P07.032)

Abstract

Objective: To investigate the relationship between acute infarct volume on diffusion-weighted imaging (DWI) and acute stress hyperglycemia (ASH) in a prospectively collected dataset. Background The published evidence on the relationship between ischemic lesion volume and ASH is conflicting. While some studies report higher infarct volumes in patients with ASH, others refute this by claiming that small infarcts such as lacunar infarcts are also associated with ASH. Small sample size, failure to use a consistent definition for ASH, inability to account for differences in timing of infarct volume and glucose measurements, and differences in infarct size determination contribute to the controversy. We sought to investigate the relationship between acute infarct volume and ASH in a prospectively collected dataset within the context of the Heart-Brain Interactions Study (HBS). Design/Methods: HBS is an ongoing study aiming to identify the neuroanatomic correlates of stroke-related cardiac injury and acute stress response. We performed blood glucose measurement within 36 hours and DWI within 72 hours of symptom onset in consecutive patients enrolled to the HBS. ASH was defined as elevated blood glucose (>144 mg/dl) in the absence of elevated Hemoglobin A1c ( Results: We identified 98 consecutive patients with ASH and 217 controls out of 1240. The median infarct volume was higher in patients than controls (11 cc vs. 4 cc, p Conclusions: The study shows that infarct volume is an independent predictor of ASH. The probability of ASH increases by increasing infarct volume. Disclosure: Dr. Helenius has nothing to disclose. Dr. Avery has nothing to disclose. Dr. Polnar has nothing to disclose. Dr. Caceres has nothing to disclose. Dr. Siket has nothing to disclose. Dr. AY has nothing to disclose.