A STUDY TO ANALYSE THE ROLE OF HbA1C IN THE RISK PREDICTIONOF ISCHEMIC STROKE AND TRANSIENT ISCHEMIC ATTACKS

Background: Stroke is the second most important cause of mortality worldwide. Diabetes mellitus is a major risk factor for the development of stroke, particularly ischemic stroke. Epidemiological data show an increased risk of stroke associated with hyperglycemia. For example, in the Framingham Study the incidence of thrombotic stroke was 2.5 times higher in diabetic men and 3.6 times higher in diabetic women than in those without diabetes. However, the prevalence of hyperglycemia preceding cerebrovascular events is poorly defined, so the relative importance of hyperglycemia as a risk factor is uncertain. In particular, the importance of mild hyperglycemia, as opposed to symptomatic diabetes, as a precursor of stroke is unclear. Measurement of glycosylated hemoglobin (HbA1c), in patients with recent stroke or transient ischemic attacks (TIA) has allowed us to address this question.

Aims And Objectives:

1.       To estimate the correlation between glycosylated hemoglobin levels and ischemic stroke/transient ischemic attacks.

2.       To investigate the usefulness of glycosylatedhemoglobin in accurately assessing the glycemic control in stroke and transient ischemic attack patients as compared to capillary glucose levels.

Methods:This hospital based study was performed in King George hospital,Visakhapatnam, AndhraPradesh from May 2019 to August 2020.A total of 200 patients admitted with ischemic stroke and transient ischemic attacks were included in the study.All the subjects were interviewed,examined and investigated as per the predesigned proforma.

Results:Out of 200 patients studied 23 had TIA and 177 had ischemic stroke. 43.47%of TIA patients had HbA1c 6.5%.68.92% of ischemic stroke patients had HbA1c 6.5%.52.11% patients who had RBS<200mg/dl had HbA1c 6.5%. 58.69% patients of known diabetic history had HbA1c 6.5%. 68.18% patients with no known diabetic history had HbA1c 6.5%.

Conclusion:Hyperglycemia recognized or unrecognized is a major risk factor for stroke. HbA1C may be a better indicator of glycemic status than RBS in stroke.Achieving an HbA1c target of less than 7% in diabetic patients is very important to prevent stroke.