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Published on: November 15, 2024
Abnormal glucose regulation increases stroke risk in minor ischemic stroke or TIA
Yuesong Pan1, Jing Jing1, Hao Li1
1From the Department of Epidemiology and Health Statistics, School of Public Health (Y.P., Y.H.), and Department of Neurology, Beijing Tiantan Hospital (Y.P., J.J., H.L., Yongjun Wang, Yilong Wang), Capital Medical University; Beijing Municipal Key Laboratory of Clinical Epidemiology (Y.P., Y.H.); China National Clinical Research Center for Neurological Diseases (J.J., H.L., Yongjun Wang, Yilong Wang); Center of Stroke (J.J., H.L., Yongjun Wang, Yilong Wang), Beijing Institute for Brain Disorders; and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (J.J., H.L., Yongjun Wang, Yilong Wang), China.
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.
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