Does impaired glucose tolerance increase the risk of stroke recurrence?

 Abnormal glucose regulation increases stroke risk in minor ischemic stroke or TIA

Pan Y, Jing J, Li H, Wang Y, Wang Y, He Y; CHANCE investigators.
Neurology 2016; 87:1551-1556.

Abstract

OBJECTIVE:

To investigate whether abnormal glucose regulation contributes to a new stroke in patients with a minor ischemic stroke or TIA.

METHODS:

We derived data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 3 groups: patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and normal fasting plasma glucose. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose regulation status and risk of stroke by multivariable Cox regression models adjusted for potential covariates.

RESULTS:

Among 5,135 included patients, 1,587 (30.9%), 409 (8.0%), and 3,139 (61.1%) patients were identified as DM, IFG, and normal glucose, respectively. Compared with normal glucose, IFG (11.0% vs 6.9%; adjusted hazard ratio [adj HR] 1.57, 95% confidence interval [CI] 1.13-2.19) and DM (15.8% vs 6.9%; adj HR 2.38, 95% CI 1.97-2.88) were associated with increased risk of stroke at 3 months after a minor stroke or TIA after adjusted for potential covariates. We found a weak J-shaped association between fasting plasma glucose and risk of stroke with a nadir of 4.9 mmol/L.

CONCLUSIONS:

Both IFG and DM were associated with an increased risk of stroke in patients with a  minor stroke or TIA.

This reference is now included in the Neurochecklist:

Ischaemic stroke: outcome

screen-shot-2016-12-24-at-23-32-53

Abstract link

D-glucose. Leighton Pritchard on Flikr. https://www.flickr.com/photos/widdowquinn/5662113812
D-glucose. Leighton Pritchard on Flikr. https://www.flickr.com/photos/widdowquinn/5662113812
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