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WSC 2022 | Intensive versus standard glucose reduction in patients with ischemic stroke undergoing EVT

Adnan Qureshi, MD, University of Missouri-Columbia, Columbia, MI, discusses the results of a post-hoc analysis of the SHINE trial (Stroke Hyperglycemia Insulin Network Effort; NCT01369069), looking at the relationship between serum glucose levels and endovascular treatment (EVT) outcomes after ischemic stroke. Looking at data in patients who have undergone mechanical thrombectomy, those with higher serum glucose levels are at higher risk of post-treatment intracerebral hemorrhage and have higher rates of death and disability. This therefore raises the question of whether significantly reducing glucose levels will reduce ischemic injury, resulting in a lower rate of death and disability. Therefore, the SHINE focused on ischemic stroke patients undergoing EVT, to analyze the effect of intensive glucose control on death and disability rates. Patients were randomized to intensive glucose treatment (serum glucose ≤110 mg/dL) versus standard glucose treatment (serum glucose ≤180 mg/dL). When considering the rates of death, serious adverse events, and favorable outcome at 90 days, there was no significant difference between groups. Thus, this trial observed no benefit of intensive glucose treatment over standard glucose treatment in patients undergoing EVT. This interview took place at the World Stroke Congress 2022 in Singapore.

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