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Updated: Nov 8, 2025
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Prediction of transient ischemic attack and minor stroke in people with type 2 diabetes mellitus
Deanna J M Isaman1, William H Herman2, Wen Ye3
1School of Nursing, University of Michigan, Ann Arbor, MI, United States of America.
Aims:
People with type 2 diabetes (T2DM) have an increased risk of transient ischemic attack and minor stroke (TIA) which are frequently followed by an ischemic stroke. We aimed to develop a predictive model for incident TIA in people with T2DM.
Methods:
We pooled data from two longitudinal cohort studies, Atherosclerosis Risk in Communities (ARIC) and the Cardiovascular Health Study (CHS), using a two-stage approach. First, we used a random effects model to interpolate risk factors of individuals between follow-up exams. Second, we used forward selection to develop a proportional hazards model for time to incident TIA. We internally validated our model using 10-fold cross-validation.
Results:
Among 3575 participants with T2DM, mean (SD) age was 60 (10) years and body mass index was 30 (6) kg/m2. Sixty-nine incident TIAs occurred during 38,364 person-years of follow-up. The multivariable model included age at diagnosis of diabetes (hazard ratio 1.13 (95% confidence interval: 1.05,1.21) per year), systolic blood pressure (1.25 (1.04,1.49) per 10 mmHg), a quadratic function of diastolic blood pressure, and history of congestive heart failure (2.08 (1.26, 3.42)). The median cross-validated Harrell's C-index was 0.80.
Conclusion:
Blood pressure and heart failure are risk factors for the earliest stages of cerebrovascular disease.
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