Key result
Global AF-related ischemic stroke incidence falls ~1% annually while diabetes-related stroke steadily rises.
Why the study?
AF-related ischemic stroke represents a cardio-cerebral comorbidity whereas diabetes-related ischemic stroke reflects panvascular disease, prompting an analysis of global burden trends using Global Burden of Diseases 2021 data.
Does the global burden of ischemic stroke attributable to diabetes versus atrial fibrillation change over time?
Observational
Does the global burden of ischemic stroke attributable to diabetes versus atrial fibrillation change over time?
The global burden of ischemic stroke is increasingly driven by diabetes, highlighting the need for comprehensive metabolic risk factor management, whereas the burden from atrial fibrillation is declining.
Rising diabetes-attributable stroke burden may prioritize metabolic risk control; this Level 3 analysis leaves open causal drivers and prevention impact.
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.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2026) conducted an observational in Ischemic stroke related to atrial fibrillation and diabetes. Atrial fibrillation and diabetes was evaluated on Average annual percentage change in age-standardized incidence rate of AF-related ischemic stroke (AAPC -0.81, 95% CI -0.92 to -0.69). Globally, the age-standardized incidence rate of AF-related ischemic stroke declined steadily (AAPC -0.81), whereas diabetes-related ischemic stroke exhibited substantial and sustained increases.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: