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Risk of ischaemic stroke among new users of glucosamine and chondroitin sulphate: a nested case-control study
Ramón Mazzucchelli1, Sara Rodríguez-Martín2, Natalia Crespí-Villarías3
1Rheumatology Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
Insights
Chondroitin sulphate (CS) and glucosamine use may reduce the risk of ischaemic stroke (IS). This study found a significant protective effect, even in patients with vascular risk factors.
Area of Science:
- Cardiovascular epidemiology
- Pharmacological interventions
- Neurology
Background:
- Chondroitin sulphate (CS) and glucosamine are associated with reduced acute myocardial infarction risk.
- Evidence for their effect on ischaemic stroke (IS) is limited.
- This study investigates the potential protective effects of CS and glucosamine against IS.
Purpose of the Study:
- To test the hypothesis that prescription glucosamine or CS reduces the risk of IS.
- To evaluate the association between glucosamine/CS use and IS incidence.
- To identify specific patient subgroups benefiting from these supplements.
Main Methods:
- A case-control study nested within an open cohort from a Spanish primary healthcare database (2002-2015).
- Incident IS cases (n=13,952) and randomly selected controls (n=69,199) were identified and matched.
- Conditional logistic regression was used to compute adjusted odds ratios (AORs) for new users of glucosamine or CS.
Main Results:
- Current use of glucosamine or CS was associated with a reduced risk of IS (AOR: 0.66; 95% CI: 0.54-0.82).
- This protective effect was consistent across sexes, age groups, and in patients with vascular risk factors.
- The benefit was significant for short-term users (<365 days) but not for long-term users.
Conclusions:
- Prescription glucosamine and CS demonstrate a protective effect against ischaemic stroke.
- The observed benefit extends to patients with vascular risk factors.
- Further research into optimal duration of use may be warranted.
Background:
Several studies have reported that the use of chondroitin sulphate (CS) and glucosamine may reduce the risk of acute myocardial infarction. Although it is thought that this potential benefit could be extended to ischaemic stroke (IS), the evidence is scarce.
Objective:
To test the hypothesis that the use of prescription glucosamine or CS reduces the risk of IS.
Design:
Case-control study nested in an open cohort.
Methods:
Patients aged 40-99 years registered in a Spanish primary healthcare database (BIFAP) during the 2002-2015 study period. From this cohort, we identified incident cases of IS, applying a case-finding algorithm and specific validation procedures, and randomly sampled five controls per case, individually matched with cases by exact age, gender and index date. Adjusted odds ratios (AORs) and 95% confidence interval (CI) were computed through a conditional logistic regression. Only new users of glucosamine or CS were considered.
Results:
A total of 13,952 incident cases of IS and 69,199 controls were included. Of them, 106 cases (0.76%) and 803 controls (1.16%) were current users of glucosamine or CS at index date, yielding an AOR of 0.66 (95% CI: 0.54-0.82) (for glucosamine, AOR: 0.55; 95% CI: 0.39-0.77; and for CS, AOR: 0.77; 95% CI: 0.60-0.99). The reduced risk among current users was observed in both sexes (men, AOR: 0.69; 95% CI: 0.49-0.98; women, AOR: 0.65; 95% CI: 0.50-0.85), in individuals above and below 70 years of age (AOR: 0.69; 95% CI: 0.53-0.89 and AOR: 0.59; 95% CI: 0.41-0.85, respectively), in individuals with vascular risk factors (AOR: 0.53; 95% CI: 0.39-0.74) and among current/recent users of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR: 0.71; 95% CI: 0.55-0.92). Regarding duration, the reduced risk was observed in short-term users (<365 days, AOR: 0.61; 95% CI: 0.48-0.78) while faded and became nonsignificant in long-term users (>364 days AOR: 0.86; 95% CI: 0.57-1.31).
Conclusions:
Our results support a protective effect of prescription CS and glucosamine in IS, which was observed even in patients at vascular risk.
Mini Abstract:
Our aim was to analyse whether the use of glucosamine or chondroitin sulphate (CS) reduces the risk of ischaemic stroke (IS). We detected a significant decrease.
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