Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Stress hyperglycemia may have higher risk of stroke recurrence than previously diagnosed diabetes mellitus
First author：Yuzhou Guo,Guangyao Wang
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Yuzhou Guo,Guangyao Wang
- Data Sources： CHANCE
- Number of papers：CHANCE20191020
- Published time：2021-03-22
2021-03-22
Published articles
Journal：Aging
Publication type: Original Research Paper
IF(IF): 4.83
PMID: 33752174 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
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.
Main results
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.