Unfavorable Neurological Outcome In Acute Ischemic Stroke Patients With Diabetes Is Associated With Incomplete Recanalization After Intravenous Thrombolysis

Objective:To assess the impact of diabetes on neurological outcome and recanalization in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT).MethodsClinical data of419consecutive patients with AIS who received IVT from June2009to April2014. Based on the medical history and new diagnosis, the patients were divided into diabetic and non-diabetic groups. Neurological outcome at24hours,7days and3months after IVT were evaluated. Unfavorable outcome was defined as National Institutes of Health Stroke Scale (NIHSS) score decrease<4points from baseline at24h, NIHSS decrease<8points at day7, or modified Rankin scale (mRS)=2at3months after IVT. Recanalization on noninvasive imaging was evaluated in patients with large vessel occlusion (LVO) according to TIMI.Results Among419patients,98(23.4%) had diabetes. Multivariable analyses showed that comorbidity of diabetes was an independent predictor of unfavorable outcome at24h (71.4%vs.59.8%, OR=0.534,95%CI0.316～0.903, P=0.019), at day7(77.6%vs.56.7%, OR=0.382,95%CI0.220-0.665, P=0.001), and at3months (68.4%vs.55.1%, OR=0.464,95%CI0.266-0.808, P=0.007). In LVO patients, diabetes was an independent predictor of incomplete recanalization24hours after IVT (9.7%vs.27.0%, OR=0.268,95%CI0.075～0.955, P=0.042).ConclusionAIS patients with diabetes had unfavorable neurological outcome, potentially linked with incomplete recanalization after IVT.