When treating stroke patients, emergency room physicians often use a “clot-busting” therapy called thrombolysis. Although the therapy works well most of the time, some patients have an elevated risk of intracerebral hemorrhage (ICH), a type of stroke, after treatment. In fact, elevated blood glucose has been shown to correlate with increased risk for ICH after thrombolysis treatment. So clinicians have typically obtained a glucose test when they treat stroke patients with thrombolysis.
Research, led by Eric Juttler, MD, of the University of Heidelberg, asked whether the Hemoglobin A1c test might be a better predictor of ICH rather than a simple fingerstick. Unlike the fingerstick which gives the glucose level for a single moment, the A1c test provides information about glucose control over the past 2 to 3 months. (How? The amount of A1c—also known as glycated hemoglobin or HbA1c—gleans information about glucose control over the lifespan of a red blood cell.)
Researchers evaluated data from 400 stroke patients admitted to their emergency department from March 1998 to October 2005. They found the A1c test (given at time of admission to the hospital) to be a better predictor of ICH risk than the traditional blood glucose, finger-stick, test. The researchers now recommend that hospitals adopt the A1c calling it a “much better screening parameter for the risk of cerebral hemorrhage after thrombolysis.”