Diabetes mellitus (adj HR 2.38, 95% CI 1.97-2.88) and impaired fasting glucose (adj HR 1.57, 95% CI 1.13-2.19) were associated with an increased 90-day risk of new stroke compared to normal glucose.
Cohort (n=5,135)
Does abnormal glucose regulation increase the risk of a new stroke in patients with a minor ischemic stroke or TIA?
In patients with minor ischemic stroke or TIA, both impaired fasting glucose and diabetes mellitus significantly increase the risk of a recurrent stroke at 90 days.
Effect estimate: adj HR 2.38 (95% CI 1.97-2.88)
Absolute Event Rate: 15.8% vs 6.9%
OBJECTIVE: To investigate whether abnormal glucose regulation contributes to a new stroke in patients with a minor ischemic stroke or TIA. METHODS: We derived data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 3 groups: patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and normal fasting plasma glucose. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose regulation status and risk of stroke by multivariable Cox regression models adjusted for potential covariates. RESULTS: Among 5,135 included patients, 1,587 (30.9%), 409 (8.0%), and 3,139 (61.1%) patients were identified as DM, IFG, and normal glucose, respectively. Compared with normal glucose, IFG (11.0% vs 6.9%; adjusted hazard ratio adj HR 1.57, 95% confidence interval CI 1.13-2.19) and DM (15.8% vs 6.9%; adj HR 2.38, 95% CI 1.97-2.88) were associated with increased risk of stroke at 3 months after a minor stroke or TIA after adjusted for potential covariates. We found a weak J-shaped association between fasting plasma glucose and risk of stroke with a nadir of 4.9 mmol/L. CONCLUSIONS: Both IFG and DM were associated with an increased risk of stroke in patients with a minor stroke or TIA. CLINICALTRIALSGOV IDENTIFIER: NCT00979589.
Pan et al. (Sat,) conducted a cohort in Minor ischemic stroke or TIA (n=5,135). Diabetes mellitus (DM) and impaired fasting glucose (IFG) vs. Normal fasting plasma glucose was evaluated on new stroke (ischemic or hemorrhagic) at 90 days (adj HR 2.38, 95% CI 1.97-2.88). Diabetes mellitus (adj HR 2.38, 95% CI 1.97-2.88) and impaired fasting glucose (adj HR 1.57, 95% CI 1.13-2.19) were associated with an increased 90-day risk of new stroke compared to normal glucose.