Globally, the incidence of diabetes-related ischemic stroke increased substantially (AAPC 1.10; 95% CI 1.02-1.18), whereas atrial fibrillation-related ischemic stroke declined (AAPC -0.81).
Observational
Yes
The global incidence of ischemic stroke attributable to diabetes is rising substantially, contrasting with a steady decline in stroke attributable to atrial fibrillation.
Effect estimate: AAPC 1.10 (95% CI 1.02-1.18)
BACKGROUND: Ischemic stroke (IS) related to atrial fibrillation (AF) represents a cardio-cerebral comorbidity, whereas diabetes-related IS reflects an advanced manifestation of panvascular disease. We aimed to analyze the burden trends in AF-related and diabetes-related IS, using Global Burden of Diseases 2021 data. METHODS: To quantify the burdens of AF- and diabetes-related IS, we applied the population-attributable fraction, the proportion of burden preventable by eliminating a risk factor. We calculated population-attributable fractions stratified by time, location, and age group. We analyzed the burdens using joinpoint regression, time-series projection to 2050, and age/sex-stratified. RESULTS: Globally, AF-related IS had a higher age-standardized incidence rate in 1990 but declined steadily (average annual percentage change =-0.81 95% CI, -0.92 to -0.69). Conversely, diabetes-related IS, despite a lower initial incidence, exhibited substantial and sustained increases (average annual percentage change=1.10 95% CI, 1.02-1.18). Middle-high socio-demographic index regions experienced the greatest burden from both comorbidities. In North America and Eastern Europe, the age-standardized incidence rates of AF-related IS stabilized (average annual percentage change=-1.45 95% CI, -1.63 to -1.27; -0.95 95% CI, -1.06 to -0.84), whereas the age-standardized incidence rates of diabetes-related IS continued to increase (average annual percentage change=1.18 95% CI, 1.02-1.34; 0.72 95% CI, 0.56-0.88). High body mass index emerged as a critical shared risk factor for AF, diabetes, and IS. Projections indicate a substantial increase in diabetes-related IS incidence over the next 3 decades, contrasting with minimal growth in AF-related IS. CONCLUSIONS: IS remains a critical global health challenge, primarily driven by the rising burden of diabetes-related IS. Our findings highlight the importance of age- and country-specific interventions.
Wang et al. (Fri,) conducted a observational in Ischemic stroke related to atrial fibrillation and diabetes. Diabetes vs. Atrial fibrillation was evaluated on Average annual percentage change in age-standardized incidence rate (AAPC 1.10, 95% CI 1.02-1.18). Globally, the incidence of diabetes-related ischemic stroke increased substantially (AAPC 1.10; 95% CI 1.02-1.18), whereas atrial fibrillation-related ischemic stroke declined (AAPC -0.81).