Recurrent Stroke in Minor Ischemic Stroke or Transient Ischemic Attack With Metabolic Syndrome and/or Diabetes Mellitus. Issue 6 (9th June 2017)

• Record Type: Journal Article
• Authors: Chen, Weiqi; Pan, Yuesong; Jing, Jing; Zhao, Xingquan; Liu, Liping; Meng, Xia; Wang, Yilong; Wang, Yongjun
• Other Names: Johnston S. Claiborne investigator.; Wang Zhimin investigator.; Xia Haiqin investigator.; Li Bin investigator.; Zhang Guiru investigator.; Ren Xudong investigator.; Ji Chunling investigator.; Zhang Guohua investigator.; Li Jianhua investigator.; Lu Bohua investigator.; Wang Liping investigator.; Feng Shutao investigator.; Wang Dali investigator.; Tang Weiguo investigator.; Li Juntao investigator.; Zhang Hongtian investigator.; Li Guanglai investigator.; Wang Baojun investigator.; Chen Yuhua investigator.; Lian Ying investigator.; Liu Bin investigator.; Teng Junfang investigator.; Sui Rubo investigator.; Li Lejun investigator.; Yuan Zhiling investigator.; Zang Dawei investigator.; Lu Zuneng investigator.; Sun Li investigator.; Wang Dong investigator.; Hou Liying investigator.; Yuan Dongcai investigator.; Cao Yongliang investigator.; Li Hui investigator.; Tan Xiuge investigator.; Wang Huicong investigator.; Du Haisong investigator.; Liu Mingyi investigator.; Wang Suping investigator.; Liu Qiuwu investigator.; Zhang Zhong investigator.; Cui Qifu investigator.; Wang Runqing investigator.; Zhao Jialin investigator.; Zhang Jiewen investigator.; Zhao Jianping investigator.; Bi Qi investigator.; Qi Xiyou investigator.; Liu Junyan investigator.; Li Changxin investigator.; Li Ling investigator.; Pan Xiaoping investigator.; Zhang Junling investigator.; Jiao Derang investigator.; Han Zhao investigator.; Qian Dawei investigator.; Xiao Jin investigator.; Xing Yan investigator.; Du Huishan investigator.; Huang Guang investigator.; Cui Yongqiang investigator.; Li Yan investigator.; Feng Lianyuan investigator.; Gao Lianbo investigator.; Xiao Bo investigator.; Cao Yibin investigator.; Wu Yiping investigator.; Liu Jinfeng investigator.; Zhang Zhiming investigator.; Dong Zhengxie investigator.; Wang Limin investigator.; He Li investigator.; Wang Xinchen investigator.; Guo Xueying investigator.; Wang Ming investigator.; Wang Xiaosha investigator.; Jiang Jiandong investigator.; Zhao Renliang investigator.; Zhou Shengnian investigator.; Hu Hao investigator.; He Maolin investigator.; Yu Fengchun investigator.; Ouyang Quping investigator.; Zhang Jingbo investigator.; Xu Anding investigator.; Qi Xiaokun investigator.; Wang Lei investigator.; Shi Fuming investigator.; Guo Fuqiang investigator.; Wang Jianfeng investigator.; Zhao Fengli investigator.; Dou Ronghua investigator.; Wei Dongning investigator.; Meng Qingwei investigator.; Xia Yilu investigator.; Wang Shimin investigator.; Xue Zhangcang investigator.; Xu Yuming investigator.; Ma Liping investigator.; Wang Chun investigator.; Wu Jiang investigator.; Du Yifeng investigator.; Wang Yinzhou investigator.; Xiao Lijun investigator.; Song Fucong investigator.; Hu Wenli investigator.; Chen Zhigang investigator.; Liu Qingrui investigator.; Zhang Jiemin investigator.; Chen Mei investigator.; Yuan Xiaodong investigator.; Liu Zhihui investigator.; Li Guozhong investigator.; Li Xiaohong investigator.; Tian Tingchen investigator.;
• Is Part Of: Journal of the American Heart Association. Volume 6:Issue 6(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-06-09
• Subjects: diabetes mellitus -- metabolic syndrome -- prognosis -- stroke; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.116.005446
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: We aimed to determine the risk conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent stroke in patients with minor ischemic stroke or transient ischemic attack from the CHANCE (Clopidogrel in High‐risk patients with Acute Non‐disabling Cerebrovascular Events) trial. Methods and Results: In total, 3044 patients were included. Patients were stratified into 4 groups: neither, METS only, DM only, or both. METS was defined using the Chinese Diabetes Society (CDS) and International Diabetes Foundation (IDF) definitions. The primary outcome was new stroke (including ischemic and hemorrhagic) at 90 days. A multivariable Cox regression model was used to assess the relationship of METS and DM status to the risk of recurrent stroke adjusted for potential covariates. Using the CDS criteria of METS, 53.2%, 17.2%, 19.8%, and 9.8% of patients were diagnosed as neither, METS only, DM only, and both, respectively. After 90 days of follow‐up, there were 299 new strokes (293 ischemic, 6 hemorrhagic). Patients with DM only (16.1% versus 6.8%; adjusted hazard ratio 2.50, 95% CI 1.89–3.39) and both (17.1% versus 6.8%; adjusted hazard ratio 2.76, 95% CI 1.98–3.86) had significantly increased rates of recurrent stroke. No interaction effect of antiplatelet therapy by different METS or DM status for the risk of recurrent stroke ( P =0.82 for interaction in the fully adjusted model of CDS) was observed. Using the METS (IDF) criteria demonstrated similar results. Conclusions: Concurrent METS and DM was associated with an increased risk of recurrent stroke in patients with minor stroke and transient ischemic attack.