Intensive Insulin Therapy and Risk for Symptomatic Intracerebral Hemorrhage After Intravenous Stroke Thrombolysis

Baseline hyperglycemia is associated with an increased risk for symptomatic intracerebral hemorrhage (sICH) in patients receiving intravenous tPA for acute ischemic stroke. In this prespecified secondary analysis of data from the SHINE trial, investigators tested the hypothesis that intensive insulin therapy for hyperglycemia would reduce the risk for post-thrombolysis sICH as compared with standard glucose control. This analysis was based on the subset of 725 patients in SHINE (out of 1151 overall) that received intravenous thrombolysis for acute ischemic stroke. SHINE participants were randomized to intensive insulin therapy (continuous intravenous infusion; target glucose, 80–130 mg/dL) or standard glucose control (sliding scale subcutan…