DISCUSSION
myocardial infarction, neuroinflammation, acute stroke, stroke, hyperglycemia, neurotoxic, vessel occlusion stroke, stress hyperglycemia, diabetes
MYOCARDIAL INFARCTION, STRESSFUL EVENTS, STROKE, HYPERGLYCEMIA, DIABETES, STRESS HYPERGLYCEMIA, CRITICAL ILLNESS, STRESS HYPERGLYCEMIA, ACUTE STROKE, INFLAMMATORY RESPONSE
In this study, we evaluated the association between the stress hyperglycemia ratio and clinical outcomes in patients with acute large vessel occlusion stroke receiving endovascular treatment. Patients received intravenous tirofiban or placebo prior to EVT. We found that, on admission, higher stress hyperglycemia of stroke patients was closely linked to unfavorable clinical outcomes. However, the association between SHR and safety outcomes was not elucidated.Patients with acute stroke or myocardial infarction have a high probability of developing stress hyperglycemia during their illness.Although this mechanism is not yet fully explored, there are several explanations for this association between stress hyperglycemia and an increased risk of adverse clinical outcomes after stroke. Firstly, higher stress hyperglycemia values may imply a greater stressful inflammatory response to acute critical illness, which promotes the progression of neuroinflammation and release of neurotoxic and vasoconstrictive factors that further damage vascular endothelial cells, leading to a reduction in vascular repair and protection.Stress hyperglycemia is strictly defined as hyperglycemia at the time of admission in patients without previous diabetes or worsening hyperglycemia in patients with diabetes and is an emergency response to a stressful event.Our study has some limitations. Firstly, since our study was a post hoc analysis of the RESCUE BT trial, excluding patients without admission glucose and HbA1C values from this study, there may exist selection bias due to the inherent limitation of the study design. Secondly, our stroke population was screened from multiple centers in China, the incidence of stroke in Western populations remains unknown. Thus, further research incorporating other populations is needed in the future to achieve generalizability.