Clinical study about effects of the acute fasting hyperglycemia and type 2 diabetes mellitus on ischemic preconditioning in patients with the first-ever acute anterior circulation infarction / 中华神经科杂志

ABSTRACT

Objectives To assess whether prodromal transient ischemic attack (TIA) has beneficial effects on type 2 diabetic patients and those had acute fasting hyperglycemia with the first-ever acute anterior circulation infarction.Methods One hundred and seventy patients with first-ever ischemic acute anterior circulation infarction were involved.According to whether they had type 2 diabetes mellitus,patients were divided into group A (non-diabetic patients) and group B (diabetic patients).Mean infarct volume was also compared between patients with pro-TIA and without pro-TIA in group A and B,and each group with acute hyperglycemia too.Results In group A,prodromal TIA was associated with a smaller infarct volume (M 2.61 cm3 vs 5.99 cm33 Z=-2.69,P=0.007).On the contrary,in group B,there was no significant difference in infarct volume (M 3.25 cm3 vs 11.0 cm3,Z=-1.699,P=0.08) between patients with and without prodromal TIA.In group A patients absent with acute fasting hyperglycemia,infarct volume significantly smaller in patients with prodromal TIA than in those without (M 2.69 cm3 vs 6.46 cm3,Z=-2.34,P=0.019) ; In patients with acute fasting hyperglycemia,there was no a significant difference in infarct volume (M 2.61 cm3 vs 5.69 cm3 ,Z=-1.218,P=0.27).However,among group B patients present or absent with acute impaired fasting glucose,there was no significant difference in infarct volume in patients with or without prodromal TIA.Conclusion Diabetes mellitus and the acute fasting hyperglycemia might prevent the ischemic preconditioning.