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Giovanni Merlino: Why Does Stress Hyperglycemia Worsen Stroke Outcomes?
Jun 23, 2026, 22:49

Giovanni Merlino: Why Does Stress Hyperglycemia Worsen Stroke Outcomes?

Giovanni Merlino, Head of the SOSD Stroke Unit at the University of Udine, shared on LinkedIn about a recent article he and his colleagues co-authored, published in JAHA, adding:

“Stress hyperglycemia worsens outcome in minor stroke. But through which mechanism?

In our new study in the JAHA — Journal of the American Heart Association, we used a causal mediation framework on 1316 patients (5 centers, Italy and the UK) and found that hemorrhagic transformation mediates ~15% of that effect on 3-month functional outcome.

The signal was strongest in younger, non-diabetic patients with elevated CRP, a possible target for future interventional trials.

A special congratulations to Francesco Bax, who led this work.

The causal mediation analysis at the core of this study is entirely his, and the result speaks for itself.”

Title: Hemorrhagic Transformation Mediates Stress Hyperglycemia Effect on Functional Outcome in Minor Ischemic Stroke

Authors: Francesco Bax, Mariarosaria Valente, Federico Mazzacane, Matteo Foschi, Raffaele Ornello, Alessandro Marè, Francesco Toraldo, Caterina Del Regno, Roberto Sperotto, Antonio Taglialatela, Beatrice Del Bello, Laura Spigariol, Lucia Pavolucci, Yan Tereshko, Carolina Gentile, Francesco Janes, Simone Lorenzut, Roberto Marinig, Simona Sacco, Anna Cavallini, Gian Luigi Gigli, Giovanni Merlino, Lucio D’Anna

Giovanni Merlino

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