Fasting blood glucose-to-glycated hemoglobin ratio and functional outcome of patients with ischemic stroke after endovascular treatment: a meta-analysis
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Abstract
Background: Stress hyperglycemia is common in acute ischemic stroke (IS) and has been linked to adverse outcomes. The fasting glucose-to-HbA1c ratio (GAR) has been proposed as a simple marker reflecting stress hyperglycemia relative to chronic glycemic status, but its prognostic value in patients undergoing endovascular treatment (EVT) remains unclear. This meta-analysis aimed to evaluate the association between GAR and 90-day functional outcomes in these patients. Methods: PubMed, Embase, Web of Science, Wanfang and CNKI were systematically searched through May 29, 2025. Studies reporting the association between GAR and poor functional outcome, defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days, were included. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for heterogeneity. Results: Twelve datasets from ten retrospective cohort studies involving 3,878 patients were analyzed. The pooled analysis showed that a high GAR was significantly associated with an increased risk of poor functional outcome at 90 days after EVT (OR: 2.94, 95% CI: 2.22–3.88, p < 0.001; I² = 14%). Meta-regression indicated that the proportion of diabetic patients showed a trend toward explaining the observed heterogeneity (coefficient = –0.0088, p = 0.08; I² residual = 0%), whereas other factors showed no significant influence. Subgroup analyses yielded consistent results across age, sex, diabetes status, NIHSS, GAR cutoffs, and study quality (p for subgroup difference all > 0.05). The certainty of evidence for the primary outcome was rated as moderate according to the GRADE framework, mainly due to the retrospective design. Conclusion: High GAR may independently predict poor 90-day functional outcomes after EVT in patients with IS, supporting its potential prognostic value in clinical practice.
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| Authors | Sun, Ying |
| Journal | Frontiers in pharmacology |
| Year | Year not found |
| DOI |
10.3389/fneur.2025.1692103
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| Keywords | Keywords not found |
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