ArticleJournal of thrombosis and thrombolysis2021
Stress hyperglycemia is predictive of worse outcome in patients with acute ischemic stroke undergoing intravenous thrombolysis.
Article in Journal of thrombosis and thrombolysis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 6 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 6 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Association of the Stress Hyperglycemia Ratio and Prognosis After Endovascular Treatment: A Systematic Review and Meta-Analysis.Brain and behavior · 2026Pooled it
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- Association between stress hyperglycemia ratio and prognosis in acute ischemic stroke: a systematic review and meta-analysis.BMC neurology · 2024Pooled it
- Stress hyperglycemia and risk of adverse outcomes in patients with acute ischemic stroke: a systematic review and dose-response meta-analysis of cohort studies.Frontiers in neurology · 2023Pooled it
- Blood glucose level affects prognosis of patients who received intravenous thrombolysis after acute ischemic stroke? A meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Association of the stress hyperglycemia ratio and clinical outcomes in patients with stroke: A systematic review and meta-analysis.Frontiers in neurology · 2022Pooled it
- Hemorrhagic Transformation Mediates Stress Hyperglycemia Effect on Functional Outcome in Minor Ischemic Stroke.Journal of the American Heart Association · 2026Article
- A multimarker panel for predicting short-term outcome after intravenous thrombolysis in acute ischemic stroke: a retrospective study.Frontiers in medicine · 2026Article
- Joint impact of stress hyperglycaemic ratio and glycaemic variability in patients with ischaemic stroke and machine learning for mortality prediction.BMC neurology · 2025Article
- Association between SHR and mortality in critically ill patients with CVD: a retrospective analysis and machine learning approach.Diabetology & metabolic syndrome · 2025Article
- Association between stress hyperglycaemia ratio and admission stroke severity: a retrospective study in a Chinese single-centre cohort.BMJ open · 2025Article
- Stress Hyperglycemia as a Prognostic Indicator of the Clinical Outcomes in Patients with Stroke: A Comprehensive Literature Review.Biomedicines · 2025Review
- Admission glucose is a significant outcome predictor in anterior circulation stroke: approaching the sweet spot.Neurological research and practice · 2025Article
- Stress hyperglycemia ratio as an important predictive indicator for severe disturbance of consciousness and all-cause mortality in critically ill patients with cerebral infarction: a retrospective study using the MIMIC-IV database.European journal of medical research · 2025Article
- Associations between stress hyperglycemia and outcomes in patients with ischemic stroke and TIA: the data comes from the Third China National Stroke Registry (CNSR-III).Metabolic brain disease · 2025Article
- The role of SHR in risk stratification for long-term prognosis in patients with coronary artery disease: findings from a large cohort study.Frontiers in endocrinology · 2025Observational
- Review
- Stress hyperglycemia is associated with futile recanalization in patients with anterior large vessel occlusion undergoing mechanical thrombectomy.European stroke journal · 2024Article
- Independent effects of the glucose-to-glycated hemoglobin ratio on mortality in critically ill patients with atrial fibrillation.Diabetology & metabolic syndrome · 2024Article
- Poor Prestroke Glycemic Control Increases the Rate of Symptomatic Intracranial Hemorrhage after Mechanical Thrombectomy.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
No study investigated the possible detrimental effect of stress hyperglycemia on patients affected acute ischemic stroke (AIS) undergoing intravenous thrombolysis (IVT). A new index, the glucose-to-glycated hemoglobin ratio (GAR), has been developed for assessing stress hyperglycemia. We retrospectively analyzed data from a prospectively collected database of consecutive patients admitted to the Udine University Hospital with AIS that were treated with IVT from January 2015 to December 2019. Four hundred and fourteen consecutive patients with AIS undergoing IVT entered the study. The patients were then stratified into four groups by quartiles of GAR (Q1-Q4). The higher GAR index was, the more severe stress hyperglycemia was considered. Prevalence of 3 months poor outcome (37.7% for Q1, 34% for Q2, 46.9% for Q3, and 66.7% for Q4, p for trend = 0.001), 3 months mortality (10.5% for Q1, 7.5% for Q2, 11.2% for Q3, and 27.1% for Q4, p for trend = 0.001), and symptomatic intracranial hemorrhage (0.9% for Q1, 0.9% for Q2, 5.1% for Q3, and 17.7% for Q4, p for trend = 0.001) was significant different among the four groups. AIS patients with severe stress hyperglycemia had a significantly increased risk of 3 months poor outcome (OR 2.43, 95% CI 1.14-5.22, p = 0.02), 3 months mortality (OR 2.38, 95% CI 1.01-5.60, p = 0.04), and symptomatic intracranial hemorrhage (OR 16.76, 95% CI 2.09-134.58, p = 0.008) after IVT. In conclusion, we demonstrated that stress hyperglycemia, as measured by the GAR index, is associated to worse outcome in AIS patients undergoing IVT.
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