国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

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Stress hyperglycemia may have higher risk of stroke recurrence than previously diagnosed diabetes mellitus

第一作者：Yuzhou Guo,Guangyao Wang

通讯作者：Yongjun Wang,Yilong Wang

diabetes mellitus; stress hyperglycemia; stroke; TIA; prognosis

基本信息

2021-03-22

已发表文章

发表杂志：Aging

发表类型: Original Research Paper

影响因子(IF): 4.83

PMID: 33752174 Pubmed原文链接 全文下载

主要研究背景及目的

Diabetes mellitus was an important risk factor for a poor prognosis after ischemic stroke.1 Newly diagnosed diabetes mellitus by new criteria was associated with poor prognosis at 1 year after ischemic stroke. 2 Newly diagnosed diabetes mellitus are associated with increased mortality and are more likely to have poorer functional outcomes and more severe stroke than those with previously diagnosed diabetes mellitus.3 However, very few studies have compared the risk of recurrent stroke in patients with stroke with previously diagnosed diabetes mellitus and those with newly diagnosed diabetes mellitus. We used data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial to compare the risk of recurrent stroke in patients with stroke with previously diagnosed diabetes mellitus and those with newly diagnosed diabetes mellitus.

方法

Totally, 3026 patients with baseline fasting glucose and glycated albumin from the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) were included. Patients were classified as non-diabetes mellitus (non-DM), PDDM, NDDM-RH and stress hyperglycemia according to the status of glucose metabolism.

结论

Compared with PDDM in minor stroke or TIA, a parallel risk of 90-day stroke recurrence were observed for NDDM-RH, while stress hyperglycemia might relate to higher risk of 90-day stroke recurrence.

主要结果

The primary outcome was stroke recurrence during 90-day follow up. Cox regression was performed to estimate the relationship between the status of glucose metabolism and risk of 90-day stroke recurrence. Compared with PDDM, NDDM-RH had a similar risk of 90-day stroke recurrence (hazard ratios [HR]1.39, 95% confidence intervals [CI] 0.94-2.04), while stress hyperglycemia had approximately a 5.3-fold increased risk of 90-day stroke recurrence after adjusted for confounding covariates (HR 5.32, 95% CI 3.43-8.26). Parallel results were found for 90-day recurrent ischemic stroke and composite events.