Challenges in secondary stroke prevention: prevalence of multiple metabolic risk factors, including abnormal glycaemia, in ischaemic stroke and transient ischaemic attack

Greenfield, JR; Bramah, Val; Alford, Jan B; Bennett, Craig; Markus, Romesh; Campbell, Lesley V.

doi:10.1111/j.1445-5994.2009.01941.x

Cited by 10 publications

(5 citation statements)

References 35 publications

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“…Serum CRP levels are well studied as sensitive circulating markers of inflammation, as CRP is independently associated with an increased risk of cardiovascular disease and diabetes (18)(19)(20)(21)(22). In addition to these previous associations, our study identifies new information regarding CRP and disease outcomes.…”

Section: Discussionmentioning

confidence: 72%

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

et al. 2014

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OBJECTIVETo assess the prospective association between baseline serum hs-CRP concentration and the subsequent risk of development or progression of diabetic nephropathy. RESEARCH DESIGN AND METHODSLongitudinal data were obtained from 2,518 patients with type 2 diabetes registered in a Japanese diabetes registry. To assess the independent correlations between serum baseline hs-CRP and either the development or progression of diabetic nephropathy 1 year later, the Cox proportional hazards model was used and adjusted for potential confounders. RESULTSThe mean patient age, BMI, and HbA 1c level were 66.1 years, 24.6 kg/m 2 , and 7.5% (57.6 mmol/mol), respectively. Baseline serum hs-CRP levels were significantly associated with the urinary albumin-to-creatinine ratio at baseline (P < 0.001). Multivariable adjusted hazard ratio for the development from normoalbuminuria to microalbuminuria was 1.31 (95% CI 0.80-2.17; P = 0.286), 1.55 (1.16-2.08; P = 0.003), and 1.57 (1.22-2.03; P = 0.001), respectively, for the second, third, and fourth quartiles of serum hs-CRP levels, showing a statistically significant linear trend across categories (P < 0.001). We did not observe a significant association between hs-CRP levels and the subsequent risk of diabetic nephropathy progression (P for trend = 0.575). CONCLUSIONSSerum hs-CRP levels, independent of possible confounders, were associated with a subsequent risk of developing, not progressing, diabetic nephropathy in type 2 diabetic patients. Serum hs-CRP may be useful for predicting the future risk of developing diabetic nephropathy.

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Section: Discussionmentioning

confidence: 72%

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

et al. 2014

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“…A retrospective audit from a tertiary Sydney metropolitan hospital found 25% of IS/TIA patients had pre-existing DM, while 10% of them had newly diagnosed DM based on fasting and/or random plasma glucose. 24 In a recent prospective observational study conducted in Melbourne, 26% of stroke patients had pre-existing DM, and 4.9% were newly diagnosed based on an admission HbA1c value of ≥6.5%. 25 This observed increased prevalence of DM in strokes correlates with the rising proportion of diabetic patients in the general Australian population.…”

Section: Discussionmentioning

confidence: 99%

“…Their data showed that stress hyperglycaemia and newly diagnosed DM conferred a poor prognosis. A retrospective audit from a tertiary Sydney metropolitan hospital found 25% of IS/TIA patients had pre‐existing DM, while 10% of them had newly diagnosed DM based on fasting and/or random plasma glucose 24 . In a recent prospective observational study conducted in Melbourne, 26% of stroke patients had pre‐existing DM, and 4.9% were newly diagnosed based on an admission HbA1c value of ≥6.5% 25 .…”

Section: Discussionmentioning

confidence: 99%

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Low

O'Connor

et al. 2022

Internal Medicine Journal

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Background Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population. Aims We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including subanalyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS). Methods We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016. Demographic data, cardiovascular risk factors, aetiology/territory of IS, pre‐morbid DM status, indicators of glycaemic control and renal impairment were recorded. Results DM was present in 28.5% of IS and TIA patients, including 4% being newly diagnosed. Among diabetic IS patients, 45.3% had poor glycaemic control (HbA1c ≥7.0%) while 16% had moderate to severe renal impairment (estimated glomerular filtration rate of <30). The majority of IS were partial anterior circulation stroke (53.4%) and cardioembolism was the commonest mechanism (43.5%). We found no significant association between DM and a specific stroke location or mechanism. Conclusions Almost one‐third of IS/TIA patients had DM, with a significant proportion showing poor glycaemic control. The DM prevalence in our cohort was comparable with reported rates from other developed countries. Although we found no association between DM and a particular stroke type or mechanism, it is likely a reflection of our cohort size. Our study demonstrated that DM, as a significant risk factor in IS, warrants early detection and better management strategies.

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“…7,8 However, 67% to 85% of patients with stroke stop treatment within 3 months of discharge. 9 After stroke onset, 46.2% of these patients do not take the required medication. 10 In addition, after diagnosis, more than 25% of stroke patients engage in smoking, drinking alcohol, noncompliance with a low-salt diet, or insufficient physical activity.…”

mentioning

confidence: 99%

“…Self-management decreases the risk of recurrent vascular events in patients with stroke by approximately 80% or more and reduces hospital admission and mortality 7,8 . However, 67% to 85% of patients with stroke stop treatment within 3 months of discharge 9 . After stroke onset, 46.2% of these patients do not take the required medication 10 .…”

mentioning

confidence: 99%

Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors

Jeong,

Kim,

Kang

2024

CIN: Computers, Informatics, Nursing

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This study aimed to develop a Mobile Application to Prevent Recurrent Stroke to prevent recurrent stroke by enhancing self-management and to evaluate its effects on stroke survivors' health outcomes. The Mobile Application to Prevent Recurrent Stroke was developed based on social cognitive theory and the model in order of analysis, design, development, implementation, and evaluation process. The Mobile Application to Prevent Recurrent Stroke consisted of health management contents such as information about stroke, its associated risk factors, and required skills to conduct self-management with tailored support and counseling. A quasi-experimental preintervention and postintervention design was used involving a total of 54 stroke survivors. The experimental group (n = 27) was provided the Mobile Application to Prevent Recurrent Stroke for 8 weeks, whereas the control group (n = 27) received an education booklet. The result revealed that medication adherence (P = .002), healthy eating habit (P < .001), physical activity (P < .001), and affected-side grip strength (P = .002) in the experimental group were significantly better than those in the control group. The systolic blood pressure (P = .020), diastolic blood pressure (P < .001), body mass index (P < .001), and waist circumference (P < .001) in the experimental group were significantly lower than those in the control group. Stroke survivors can easily use this Mobile Application to Prevent Recurrent Stroke to improve self-management. Nurses can provide tailored care based on the lifelogging data of stroke survivors to prevent recurrent stroke.

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Challenges in secondary stroke prevention: prevalence of multiple metabolic risk factors, including abnormal glycaemia, in ischaemic stroke and transient ischaemic attack

Cited by 10 publications

References 35 publications

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

Serum High-Sensitivity C-Reactive Protein Levels Are Associated With High Risk of Development, Not Progression, of Diabetic Nephropathy Among Japanese Type 2 Diabetic Patients: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT7])

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors

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