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Journal article
Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes
Neurology, v 85(11), pp 935-941
15 Sep 2015
PMID: 26296518
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objectives:We used a prospective clinical trial to examine the risks conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent strokes in the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort.Methods:The SPS3 trial enrolled 3,020 patients with lacunar strokes. Participants were stratified into groups of METS only, DM only, both, or neither using American Heart Association/National Heart, Lung, and Blood Institute and World Health Organization guidelines. Annualized event rates of strokes, myocardial infarction (MI), and all-cause mortality were calculated, and hazard ratios (HRs) referencing the neither group were computed, controlling for significantly associated baseline characteristics.Results:Among 2,999 participants, 25% had METS only, 6% had DM only, 32% had both conditions, and 37% had neither. Over a median of 3.8 years of follow-up, there were 274 recurrent strokes (240 ischemic, 34 hemorrhagic) and 74 MIs; among the 240 ischemic strokes, 134 (56%) were lacunar. The rates of any recurrent stroke (HR 1.7, 95% confidence interval [CI] 1.3-2.3) or lacunar stroke (HR 2.4, 95% CI 1.5-3.7) were significantly higher for those with concurrent METS and DM compared with those who had neither. Risk of incident MI was higher in participants with DM (HR 2.8, 95% CI 1.1-7.0) or concurrent DM and METS (HR 2.6, 95% CI 1.4-4.9).Conclusion:METS and DM were significant comorbid conditions in lacunar stroke patients and they were associated with stroke recurrence. In patients with lacunar infarcts, a vigilant approach to prevent development of DM in those with METS may be a potential strategy to reduce recurrent strokes. Neurology (R) 2015;85:935-941
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- Title
- Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes
- Creators
- Shuhan Zhu - Boston UniversityLeslie A. McClure - University of Alabama at BirminghamHelena Lau - Boston UniversityJose R. Romero - Boston UniversityCarole L. White - Health Restoration & Care System ManagementViken Babikian - Boston UniversityThanh Nguyen - Boston UniversityOscar R. Benavente - University of British ColumbiaCarlos S. Kase - Boston UniversityAleksandra Pikula - University of Toronto
- Publication Details
- Neurology, v 85(11), pp 935-941
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Grant note
- U01NS038529 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) U01 NS38529 / National Institute of Neurological Disorders and Stroke (NINDS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) NIH/NHLBI (National Heart, Lung, and Blood Institute); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000364720500004
- Scopus ID
- 2-s2.0-84947270883
- Other Identifier
- 991019231724404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology