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Submitted
5 May 2021
Accepted
18 March 2024
Published
10 June 2024
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Abstract

Highlights:
1. The findings of this study indicate that clinicians should remain vigilant, as effective glycemic control, reflected by optimal HbA1c levels, does not necessarily correlate with favorable distal cerebrovascular resistance, as measured by pulsatility index (PI).
2. This study recommends that patients with acute thrombotic stroke undergo a comprehensive examination to ensure an accurate diagnosis and appropriate treatment.


 


Abstract


Stroke is the second leading cause of death and disability in the world. Diabetes mellitus is a risk factor for stroke with an increase in blood viscosity associated with hyperglycemia, and HbA1c is a well-established biomarker primarily used for the long-term monitoring of glycemic control in patients with diabetes mellitus. The Pulsatility index (PI) parameter of Trans Cranial Doppler (TCD) can measure blood vessel resistance. This study was to prove the correlation between HbA1c and PI in Middle Cerebral Artery (MCA) of acute thrombotic stroke patients. A cross-sectional study was conducted to thrombotic stroke patients treated at the neurological ward of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from March 2019 to April 2020 who met the inclusion and exclusion criteria. Data were obtained from medical records. Statistical analysis was performed using Spearman test for numerical data and Chi-square for categorical data with a significant value of p <0.05. There were 32 subjects who met the inclusion and exclusion criteria. A total of 24 subjects (75%) were males and 8 (25%) females with a mean age of 56.41±13.22 years. PI MCA results were abnormal in 14 subjects (43.75%) with an average of 1.8±0.97 and PI MCA was normal in 18 subjects (56.25%) with an average of 0.87±0.15. The average HbA1c was 6.55±1.9%. There was no statistically significant association observed between HbA1c and PI in MCA examination (r=0.07; p=0.73). In conclusion, the findings of this study indicate the lack of correlation between pulsatility index and HbA1c in patients with acute ischemic stroke. This underscores the importance of comprehensive cerebrovascular evaluation regardless of HbA1c status.

Keywords

Acute thrombotic stroke HbA1c Trans Cranial Doppler Pulsatility Index blood viscosity diabetes mellitus

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How to Cite
Rio Tasti Surpa Rahmat Bintan, Sita Setyowati, & Yudhi Adrianto. (2024). HbA1c and Pulsatility Index in Middle Cerebral Artery of Patients with Acute Thrombotic Stroke. Folia Medica Indonesiana, 60(2), 141–146. https://doi.org/10.20473/fmi.v60i2.26698
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References

  1. Almarshad HA, Hassan FM (2016). Alterations in blood coagulation and viscosity among young male cigarette smokers of Al-Jouf Region in Saudi Arabia. Clinical and Applied Thrombosis/ Hemostasis22, 386–389. doi: 10.1177/107602961 4561319.
  2. Bill O, Lambrou D, Sotomayor GT, et al (2020). Predictors of the pulsatility index in the middle cerebral artery of acute stroke patients. Scientific Reports 10, 17110. doi: 10.1038/s41598-020-74056-2.
  3. í‡ekici Y, Kılıç S, Saraçoğlu E, et al (2019). The relationship between blood viscosity and isolated coronary artery ectasia. Acta Cardiologica Sinica 35, 20–26. doi: 10.6515/ACS.201901_35(1).2018 0701A.
  4. Chugh C (2019). Acute ischemic stroke: Management approach. Indian Journal of Critical Care Medicine 23, 140–146. doi: 10.5005/jp-journals-10071-23192.
  5. Farhoudi M, Mehrvar K, Aslanabadi N, et al (2011). Doppler study of cerebral arteries in hypercholesterolemia. Vascular Health and Risk Management 2011, 203–207. doi: 10.2147/VHRM .S18663.
  6. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. (2014). Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet 383, 245–255. doi: 10.1016/S0140-6736(13)61953-4.
  7. Filatova O V., Sidorenko AA, Agarkova SA (2015). Effects of age and sex on rheological properties of blood. Human Physiology 41, 437–443. doi: 10.1134/S0362119715030044.
  8. Fu S, Zhang J, Zhang H, et al (2019). Predictive value of transcranial doppler ultrasound for cerebral small vessel disease in elderly patients. Arquivos de Neuro-Psiquiatria 77, 310–314. doi: 10.1590/0004-282x20190050.
  9. Han JE, Kim T, Park JH, et al (2019). Middle cerebral artery pulsatility is highly associated with systemic blood viscosity in acute ischemic stroke within 24 hours of symptom onset. Journal of Neurosonology and Neuroimaging 11, 126–131. doi: 10.31728/jnn.2019.00050.
  10. Harris S, Kurniawan M, Rasyid A, et al (2018). Cerebral small vessel disease in Indonesia: Lacunar infarction study from Indonesian Stroke Registry 2012–2014. SAGE Open Medicine 6. doi: 10.1177/2050312118784312.
  11. IBM Corp. 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. Available at: https://www.ibm.com/support/pages/download ing-ibm-spss-statistics-25.
  12. Irace C, Carallo C, Scavelli F, et al (2014). Blood viscosity in subjects with normoglycemia and prediabetes. Diabetes Care 37, 488–492. doi: 10.2337/dc13-1374.
  13. Jung LY, Lee SR, Jung JM, et al (2016). Rosuvastatin reduces blood viscosity in patients with acute coronary syndrome. Korean Circulation Journal 46, 147. doi: 10.4070/kcj.2016.46.2.147.
  14. Kanyal N (2015). The science of ischemic stroke: Pathophysiology & pharmacological treatment. International Journal of Pharma Research & Review 4, 65–84. Available at: https://www.rroij. com/open-access/the-science-of-ischemic-stroke-pathophysiology--pharmacological-treatment-.pdf.
  15. Kusuima Y, Venketasubramanian N, Kiemas LS, et al (2009). Burden of stroke in Indonesia. International Journal of Stroke 4, 379–380. doi: 10.1111/j.1747-4949.2009.00326.x.
  16. Lau VI, Arntfield RT (2017). Point of care transcranial doppler by intensivists. Critical Ultrasound Journal 9, 21. doi: 10.1186/s13089-017-0077-9.
  17. Lerstad G, Brodin EE, Enga KF, et al (2014). Hyperglycemia, assessed according to HbA1c, and future risk of venous thromboembolism: the Tromsí¸ study. Journal of Thrombosis and Haemostasis 12, 313–319. doi: 10.1111/jth.12498.
  18. Minato S, Takenouchi A, Uchida J, et al (2017). Association of whole blood viscosity with metabolic syndrome in type 2 diabetic patients: Independent association with post-breakfast triglyceridemia. Journal of Clinical Medicine Research 9, 332–338. doi: 10.14740/jocmr2885w.
  19. Minister of Health of the Republic of Indonesia (2018). Report on result of national basic health research (RISKSDAS) 2018. Minist Heal Repub Indones. Available at: https://kesmas.kemkes.go. id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf.
  20. Mushtaq M, Abdul Mateen M, Kim UH (2019). Hyperglycemia associated blood viscosity can be a nexus stimuli. Clinical Hemorheology and Microcirculation 71, 103–112. doi: 10.3233/CH-180426.
  21. Shen Y, Shi L, Nauman E, et al (2020). Association between hemoglobin A1c and stroke risk in patients with type 2 diabetes. Journal of Stroke 22, 87–98. doi: 10.5853/jos.2019.01704.
  22. Shimada S, Hasegawa K, Wada H, et al (2011). High blood viscosity is closely associated with cigarette smoking and markedly reduced by smoking cessation. Circulation Journal 75, 185–189. doi: 10.1253/circj.CJ-10-0335.
  23. Taco-Vasquez ED, Barrera F, Serrano-Duenas M, et al (2019). Association between blood viscosity and cardiovascular risk factors in patients with arterial hypertension in a high altitude setting. Cureus. doi: 10.7759/cureus.3925.
  24. Wang H, Cheng Y, Chen S, et al (2019). Impact of elevated hemoglobin A1c levels on functional outcome in patients with acute ischemic stroke. Journal of Stroke and Cerebrovascular Diseases 28, 470–476. doi: 10.1016/j.jstrokecerebrovasdis. 2018.10.026.
  25. World Health Organization (2012). Global health estimates. WHO. Available at: https://www.who.int/data/global-health-estimates.