Recurrent Stroke in Minor Ischemic Stroke or Transient Ischemic Attack With Metabolic Syndrome and/or Diabetes Mellitus
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Published:2017-11-06
Issue:6
Volume:6
Page:
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ISSN:2047-9980
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Container-title:Journal of the American Heart Association
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language:en
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Short-container-title:JAHA
Author:
Chen Weiqi1234, Pan Yuesong15234, Jing Jing1234, Zhao Xingquan1234, Liu Liping1234, Meng Xia1234, Wang Yilong1234, Wang Yongjun1234, Johnston S. Claiborne, Wang Zhimin, Xia Haiqin, Li Bin, Zhang Guiru, Ren Xudong, Ji Chunling, Zhang Guohua, Li Jianhua, Lu Bohua, Wang Liping, Feng Shutao, Wang Dali, Tang Weiguo, Li Juntao, Zhang Hongtian, Li Guanglai, Wang Baojun, Chen Yuhua, Lian Ying, Liu Bin, Teng Junfang, Sui Rubo, Li Lejun, Yuan Zhiling, Zang Dawei, Lu Zuneng, Sun Li, Wang Dong, Hou Liying, Yuan Dongcai, Cao Yongliang, Li Hui, Tan Xiuge, Wang Huicong, Du Haisong, Liu Mingyi, Wang Suping, Liu Qiuwu, Zhang Zhong, Cui Qifu, Wang Runqing, Zhao Jialin, Zhang Jiewen, Zhao Jianping, Bi Qi, Qi Xiyou, Liu Junyan, Li Changxin, Li Ling, Pan Xiaoping, Zhang Junling, Jiao Derang, Han Zhao, Qian Dawei, Xiao Jin, Xing Yan, Du Huishan, Huang Guang, Cui Yongqiang, Li Yan, Feng Lianyuan, Gao Lianbo, Xiao Bo, Cao Yibin, Wu Yiping, Liu Jinfeng, Zhang Zhiming, Dong Zhengxie, Wang Limin, He Li, Wang Xinchen, Guo Xueying, Wang Ming, Wang Xiaosha, Jiang Jiandong, Zhao Renliang, Zhou Shengnian, Hu Hao, He Maolin, Yu Fengchun, Ouyang Quping, Zhang Jingbo, Xu Anding, Qi Xiaokun, Wang Lei, Shi Fuming, Guo Fuqiang, Wang Jianfeng, Zhao Fengli, Dou Ronghua, Wei Dongning, Meng Qingwei, Xia Yilu, Wang Shimin, Xue Zhangcang, Xu Yuming, Ma Liping, Wang Chun, Wu Jiang, Du Yifeng, Wang Yinzhou, Xiao Lijun, Song Fucong, Hu Wenli, Chen Zhigang, Liu Qingrui, Zhang Jiemin, Chen Mei, Yuan Xiaodong, Liu Zhihui, Li Guozhong, Li Xiaohong, Tian Tingchen,
Affiliation:
1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China 2. China National Clinical Research Center for Neurological Diseases, Beijing, China 3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China 4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China 5. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
Abstract
Background
We aimed to determine the risk conferred by metabolic syndrome (
METS
) and diabetes mellitus (
DM
) to recurrent stroke in patients with minor ischemic stroke or transient ischemic attack from the CHANCE (Clopidogrel in High‐risk patients with Acute Non‐disabling Cerebrovascular Events) trial.
Methods and Results
In total, 3044 patients were included. Patients were stratified into 4 groups: neither,
METS
only,
DM
only, or both.
METS
was defined using the Chinese Diabetes Society (
CDS
) and International Diabetes Foundation (
IDF
) definitions. The primary outcome was new stroke (including ischemic and hemorrhagic) at 90 days. A multivariable Cox regression model was used to assess the relationship of
METS
and
DM
status to the risk of recurrent stroke adjusted for potential covariates. Using the
CDS
criteria of
METS
, 53.2%, 17.2%, 19.8%, and 9.8% of patients were diagnosed as neither,
METS
only,
DM
only, and both, respectively. After 90 days of follow‐up, there were 299 new strokes (293 ischemic, 6 hemorrhagic). Patients with
DM
only (16.1% versus 6.8%; adjusted hazard ratio 2.50, 95% CI 1.89–3.39) and both (17.1% versus 6.8%; adjusted hazard ratio 2.76, 95%
CI
1.98–3.86) had significantly increased rates of recurrent stroke. No interaction effect of antiplatelet therapy by different
METS
or
DM
status for the risk of recurrent stroke (
P
=0.82 for interaction in the fully adjusted model of
CDS
) was observed. Using the
METS
(
IDF
) criteria demonstrated similar results.
Conclusions
Concurrent
METS
and
DM
was associated with an increased risk of recurrent stroke in patients with minor stroke and transient ischemic attack.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
37 articles.
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