{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:06:40Z","timestamp":1788448000834,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although endovascular therapy (EVT) is effective for large ischemic region strokes, the impact of hyperglycemia remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed data from the RESCUE\u2010Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra\u2010Acute Embolism\u2010Japan Large Ischemic Core) trial, which randomized stroke patients with Alberta Stroke Program Early Computed Tomography Score of 3 to 5 to EVT versus medical management. Outcomes were compared among patients with normoglycemia (&lt;140\u2009mg\/dL), moderate hyperglycemia (\u2265140, &lt;180\u2009mg\/dL), and severe hyperglycemia (\u2265180\u2009mg\/dL) on admission. Among 200 patients (median age 76.5\u2009years, median glucose level 131\u2009mg\/dL, EVT 50%), diabetes prevalence was 10.0%, 18.4%, and 71.0% in the groups with normoglycemia (n=120), moderate hyperglycemia (n=49), and severe hyperglycemia (n=31), respectively. Achievement of modified Rankin Scale score 0 to 3 at 90\u2009days was less frequent in the group with severe hyperglycemia (6.5%) than in the groups with normoglycemia (25.0%) and moderate hyperglycemia (24.5%), with adjusted odds ratios (aOR) of 1.48 (95% CI, 0.59\u20133.72) for moderate and 0.17 (95% CI, 0.03\u20130.95) for severe hyperglycemia relative to normoglycemia. The risk of symptomatic intracranial hemorrhage was higher for moderate hyperglycemia (6.1%; aOR, 2.86 [95% CI, 0.42\u201319.71]) and particularly for severe hyperglycemia (25.8%; aOR, 18.59 [95% CI, 2.47\u2013139.87]) compared with normoglycemia (2.5%). Symptomatic intracranial hemorrhage rates were similar for EVT and medical management in normoglycemia (1.6% versus 3.4%) and moderate hyperglycemia (5.0% versus 6.9%), but for severe hyperglycemia, the rate was higher in patients with EVT (36.8%) than in those without (8.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Severe hyperglycemia was associated with worse functional prognosis and increased symptomatic intracranial hemorrhage in large ischemic region strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\u00a0\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      . Identifier: NCT03702413.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.034556","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T06:38:10Z","timestamp":1732257490000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Detrimental Effect of Acute Hyperglycemia on the Outcomes of Large Ischemic Region Stroke"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3291-5083","authenticated-orcid":false,"given":"Kanta","family":"Tanaka","sequence":"first","affiliation":[{"name":"Division of Stroke Care Unit National Cerebral and Cardiovascular Center Suita Japan"},{"name":"Stroke Center Kindai University Hospital Osakasayama 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