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Recurrent Stroke in Minor Ischemic Stroke or Transient Ischemic Attack With Metabolic Syndrome and/or Diabetes Mellitus

Author:
Weiqi Chen  Yuesong Pan  Jing Jing  Xingquan Zhao  Liping Liu  Xia Meng  Yilong Wang  Yongjun Wang  S. Claiborne Johnston  Zhimin Wang  Haiqin Xia  Bin Li  Guiru Zhang  Xudong Ren  Chunling Ji  Guohua Zhang  Jianhua Li  Bohua Lu  Liping Wang  Shutao Feng  Dali Wang  Weiguo Tang  Juntao Li  Hongtian Zhang  Guanglai Li  Baojun Wang  Yuhua Chen  Ying Lian  Bin Liu  Junfang Teng  Rubo Sui  Lejun Li  Zhiling Yuan  Dawei Zang  Zuneng Lu  Li Sun  Dong Wang  Liying Hou  Dongcai Yuan  Yongliang Cao  Hui Li  Xiuge Tan  Huicong Wang  Haisong Du  Mingyi Liu  Suping Wang  Qiuwu Liu  Zhong Zhang  Qifu Cui  Runqing Wang  Jialin Zhao  Jiewen Zhang  Jianping Zhao  Qi Bi  Xiyou Qi  Junyan Liu  Changxin Li  Ling Li  Xiaoping Pan  Junling Zhang  Derang Jiao  Zhao Han  Dawei Qian  Jin Xiao  Yan Xing  Huishan Du  Guang Huang  Yongqiang Cui  Yan Li  Lianyuan Feng  Lianbo Gao  Bo Xiao  Yibin Cao  Yiping Wu  Jinfeng Liu  Zhiming Zhang  Zhengxie Dong  Limin Wang  Li He  Xinchen Wang  Xueying Guo  Ming Wang  Xiaosha Wang  Jiandong Jiang  Renliang Zhao  Shengnian Zhou  Hao Hu  Maolin He  Fengchun Yu  Quping Ouyang  Jingbo Zhang  Anding Xu  Xiaokun Qi  Lei Wang  Fuming Shi  Fuqiang Guo  Jianfeng Wang  Fengli Zhao  Ronghua Dou  Dongning Wei  Qingwei Meng  Yilu Xia  Shimin Wang  Zhangcang Xue  Yuming Xu  Liping Ma  Chun Wang  Jiang Wu  Yifeng Du  Yinzhou Wang  Lijun Xiao  Fucong Song  Wenli Hu  Zhigang Chen  Qingrui Liu  Jiemin Zhang  Mei Chen  Xiaodong Yuan  Zhihui Liu  Guozhong Li  Xiaohong Li  Tingchen Tian  


Journal:
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease


Abstract(summary):

BackgroundWe 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 ResultsIn 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.ConclusionsConcurrent METS and DM was associated with an increased risk of recurrent stroke in patients with minor stroke and transient ischemic attack.


Page:
1344-1349


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