Prevalence and In-hospital outcomes of diabetes among acute ischemic stroke patients in china: results from the Chinese Stroke Center Alliance

Abstract

Background Patients with ischemic stroke and diabetes are classified as extreme risk for secondary prevention, with much attention and specific management. However, the up-to-date information regarding the burden of diabetes in acute ischemic stroke (AIS) patients is lacking in China, and evidence for an association between diabetes and in-hospital outcomes after AIS remains controversial. Methods This quality improvement study was conducted at 1,476 participating hospitals in the Chinese Stroke Center Alliance between 2015 and 2019. Prevalence of diabetes was evaluated in the overall study population and different subgroups. The association between diabetes and in-hospital outcomes in AIS patients was analyzed by using multivariable logistic regression analysis and propensity score-matched analysis. Results Of 838,229 patients with AIS, 286,252 (34.2%) had diabetes/possible diabetes. The prevalence of diabetes/possible diabetes was higher in women than in men (37.6% versus 32.1%). Patients with diabetes/possible diabetes had higher rates of adverse in-hospital outcomes than those without. Multivariable analysis revealed a significant association between diabetes/possible diabetes and adverse in-hospital outcomes (all-cause mortality: odds ratio [OR], 1.30 [95% confidence interval [CI], 1.23–1.38]; major adverse cardiovascular events (MACEs): OR, 1.08 [95% CI, 1.06–1.10]) in AIS patients. The excess risk of in-hospital outcomes still remained in AIS patients with diabetes/possible diabetes after propensity score-matching analysis (all-cause mortality: OR, 1.26 [95% CI, 1.17–1.35]; MACEs: OR, 1.07 [95% CI, 1.05–1.10]). Conclusion Diabetes was highly prevalent among AIS patients in China and associated with worse in-hospital outcomes. Greater efforts to increase targeted approach to secondary prevention treatments of diabetes in AIS patients are warranted.

Early warning model for stroke recurrence in acute ischemic stroke patients based on traditional Chinese medicine syndrome theory

“…viduals with a smoking history face a significantly increased risk of a second ischemic stroke when compared to non-smokers [21,22]. The detrimental effects of smoking on the cardiovascular system, such as vascular damage, heightened blood pressure, and the promotion of blood clot formation, are welldocumented contributors to stroke incidence [23][24][25]. Effective reduction of recurrent ischemic stroke risk among former smokers necessitates the implementation of smoking cessation programs.…”

Smokers with Elevated Glycated Albumin Could Not Benefit from Dual Antiplatelet Therapy after Minor Stroke or Transient Ischemic Attack

“…As approximately 1-2 of the patients with ischemic cerebrovascular disease were smokers and one-third have diabetes, it is urgent to find an effective dual antiplatelet therapy for smokers with diabetes after minor stroke or TIA instead of clopidogrel-aspirin therapy [32][33][34]. Ticagrelor combined with aspirin may be an appropriate choice.…”

Association of baseline fasting plasma glucose with 1-year mortality in non-diabetic patients with acute cerebral infarction: a multicentre observational cohort study

“…Previous studies have demonstrated that people with diabetes have an increased risk of mortality from stroke 5 6. In China, a third of acute ischaemic stroke cases are thought to be due to diabetes mellitus or possible diabetes, with most patients having no known history of diabetes 5. However, the association of blood glucose with mortality in patients without diabetes who had a stroke has rarely been investigated.…”

“… 5 6 In China, a third of acute ischaemic stroke cases are thought to be due to diabetes mellitus or possible diabetes, with most patients having no known history of diabetes. 5 However, the association of blood glucose with mortality in patients without diabetes who had a stroke has rarely been investigated. Many patients with acute stroke may present with hyperglycaemia, even without prediagnosed diabetes.…”