Impaired glucose metabolism and the risk of vascular events and mortality after ischemic stroke: A systematic review and meta-analysis.
Humans
Risk Assessment
Risk Factors
Ischemic Stroke
/ mortality
Recurrence
Blood Glucose
/ metabolism
Prognosis
Male
Female
Aged
Middle Aged
Diabetes Mellitus
/ mortality
Ischemic Attack, Transient
/ mortality
Biomarkers
/ blood
Time Factors
Aged, 80 and over
Prediabetic State
/ mortality
Insulin Resistance
Diabetes
Insulin resistance
Ischemic stroke
Mortality
Prediabetes
Vascular events
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
31 Aug 2024
31 Aug 2024
Historique:
received:
30
06
2024
accepted:
19
08
2024
medline:
1
9
2024
pubmed:
1
9
2024
entrez:
31
8
2024
Statut:
epublish
Résumé
Diabetes mellitus (DM), prediabetes, and insulin resistance are highly prevalent in patients with ischemic stroke (IS). DM is associated with higher risk for poor outcomes after IS. Investigate the risk of recurrent vascular events and mortality associated with impaired glucose metabolism compared to normoglycemia in patients with IS and transient ischemic attack (TIA). Systematic literature search was performed in PubMed, Embase, Cochrane Library on 21st March 2024 and via citation searching. Studies that comprised IS or TIA patients and exposures of impaired glucose metabolism were eligible. Study Quality Assessment Tool was used for risk of bias assessment. Covariate adjusted outcomes were pooled using random-effects meta-analysis. Recurrent stroke, cardiac events, cardiovascular and all-cause mortality and composite of vascular outcomes. Of 10,974 identified studies 159 were eligible. 67% had low risk of bias. DM was associated with an increased risk for composite events (pooled HR (pHR) including 445,808 patients: 1.58, 95% CI 1.34-1.85, I DM is associated with a 56% increased relative risk of death after IS and TIA. Risk estimates regarding recurrent events are similarly high between prediabetes and DM, indicating high cardiovascular risk burden already in precursor stages of DM. There was a high heterogeneity across most outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Diabetes mellitus (DM), prediabetes, and insulin resistance are highly prevalent in patients with ischemic stroke (IS). DM is associated with higher risk for poor outcomes after IS.
OBJECTIVE
OBJECTIVE
Investigate the risk of recurrent vascular events and mortality associated with impaired glucose metabolism compared to normoglycemia in patients with IS and transient ischemic attack (TIA).
METHODS
METHODS
Systematic literature search was performed in PubMed, Embase, Cochrane Library on 21st March 2024 and via citation searching. Studies that comprised IS or TIA patients and exposures of impaired glucose metabolism were eligible. Study Quality Assessment Tool was used for risk of bias assessment. Covariate adjusted outcomes were pooled using random-effects meta-analysis.
MAIN OUTCOMES
RESULTS
Recurrent stroke, cardiac events, cardiovascular and all-cause mortality and composite of vascular outcomes.
RESULTS
RESULTS
Of 10,974 identified studies 159 were eligible. 67% had low risk of bias. DM was associated with an increased risk for composite events (pooled HR (pHR) including 445,808 patients: 1.58, 95% CI 1.34-1.85, I
DISCUSSION
CONCLUSIONS
DM is associated with a 56% increased relative risk of death after IS and TIA. Risk estimates regarding recurrent events are similarly high between prediabetes and DM, indicating high cardiovascular risk burden already in precursor stages of DM. There was a high heterogeneity across most outcomes.
Identifiants
pubmed: 39217364
doi: 10.1186/s12933-024-02413-w
pii: 10.1186/s12933-024-02413-w
doi:
Substances chimiques
Blood Glucose
0
Biomarkers
0
Types de publication
Systematic Review
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
323Informations de copyright
© 2024. The Author(s).
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