Related Experiment Video

Updated: Jul 23, 2025

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
07:51

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Published on: September 26, 2018

7.6K

Baseline Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes and Coronary Disease Versus Stroke:

Priyadarshini Balasubramanian1, Walter N Kernan2, Kevin N Sheth3

  • 1Section of Endocrinology, Department of Medicine (P.B.), Yale School of Medicine, New Haven, CT.

Stroke
|July 14, 2023
PubMed

Insights

Patients with type 2 diabetes and stroke have poorer cardiovascular risk factor control than those with coronary artery disease. This highlights a need for improved secondary prevention strategies in stroke patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Patients with type 2 diabetes (T2D) and cardiovascular disease face heightened risks of recurrent ischemic events.
  • Effective cardiovascular risk factor control is crucial for secondary prevention in these individuals.
  • Understanding risk factor control disparities among T2D patients with different macrovascular complications, specifically stroke versus coronary artery disease (CAD), remains unclear.

Purpose of the Study:

  • To investigate potential differences in cardiovascular risk factor control between T2D patients with a history of stroke and those with CAD.
  • To analyze risk factor control in T2D patients with both stroke and CAD compared to those with stroke alone.

Main Methods:

  • Cross-sectional analysis of 12,856 T2D patients from three major cardiovascular outcome trials (CARMELINA, EMPA-REG OUTCOME, CAROLINA).
  • Assessment of baseline risk factors: dyslipidemia, hypertension, smoking, and antiplatelet/anticoagulant therapy.
  • Logistic regression models were used to analyze the odds of achieving optimal control (3-4 controlled factors) versus suboptimal control (0-2 factors).

Main Results:

  • Patients with CAD alone demonstrated significantly better cardiovascular risk factor control compared to patients with stroke alone across all three trials.
  • The odds ratios for good versus suboptimal control were consistently higher for CAD patients (e.g., CARMELINA: 2.05 [1.67-2.51]).
  • When comparing patients with both CAD and stroke to those with stroke alone, the differences in risk factor control were less pronounced and not significant in the CAROLINA trial.

Conclusions:

  • A notable discordance exists in cardiovascular risk factor control among T2D patients, with stroke patients exhibiting less optimal control than CAD patients.
  • The intermediate results for patients with both conditions suggest that clinician-related factors may contribute to these control disparities.
  • These findings underscore the importance of targeted interventions to improve secondary prevention in T2D patients with cerebrovascular complications.
Abstract

Keywords:
anticoagulantcardiovascular diseasehypertensionodds ratiorisk factors

More Related Videos

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

25.9K
Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

310

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
25
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
25
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
319
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
13
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
10