Incidence and Risk Factors for Stroke in Type 2 Diabetic Patients

Giorda, Carlo; Avogaro, Angelo; Maggini, Marco; Lombardo, Flavia; Mannucci, Edoardo; Turco, Salvatore; Alegiani, Stefania Spila; Raschetti, Roberto; Velussi, Mario; Ferrannini, Ele

doi:10.1161/01.str.0000260100.71665.2f

Cited by 102 publications

(99 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the Framingham study, after the onset of angina, men had a twofold greater risk than women for both myocardial infarction and coronary death after adjustment for age and IHD risk factors (1). We described this sex effect previously in the prevalence (5) and incidence analyses of the first IHD event (12) and stroke (13) in the DAI population. In the present study, on the other hand, the incidence of minor IHD in cohort A was higher in women than in men.…”

Section: Discussionmentioning

confidence: 98%

Recurrence of Cardiovascular Events in Patients With Type 2 Diabetes

Giorda

Avogaro

Maggini³

et al. 2008

Diabetes Care

Self Cite

View full text Add to dashboard Cite

OBJECTIVE -The purpose of this study was to assess incidence of and risk factors for recurrent cardiovascular disease (CVD) in type 2 diabetes.RESEARCH DESIGN AND METHODS -We estimated the incidence of recurrent cardiovascular events in type 2 diabetic patients, aged 40 -97 years, followed by a network of diabetes clinics. The analysis was conducted separately for 2,788 patients with CVD at enrollment (cohort A) and for 844 patients developing the first episode during the observation period (cohort B).RESULTS -During 4 years of follow-up, in cohort A the age-adjusted incidence of a recurrent event (per 1,000 person-years) was 72.7 (95% CI 58.3-87.1) in men and 32.5 (21.2-43.7) in women, whereas in cohort B it was 40.1 (17.4 -62.9) in men and 22.4 (12.9 -32.0) in women. After controls were included for potential predictors (familial CVD, obesity, smoking, diabetes duration, glycemic control, microvascular complications, geographic area, and antihypertensive and lipid-lowering treatment), male sex, older age, and insulin use were significant independent risk predictors (cohort A) and serum triglyceride levels Ն1.69 mmol/l emerged as the only metabolic (negative) prognostic factor (cohort B). In both cohorts, a prior CVD episode, especially myocardial infarction, was by far the strongest predictor of recurrent CVD.CONCLUSIONS -Approximately 6% of unselected diabetic patients in secondary prevention develop recurrent major CVD every year. Those with long-standing previous CVD show a higher incidence of recurrence. Male sex, age, high triglyceride levels, and insulin use are additional predictors of recurrence.

show abstract

Section: Discussionmentioning

confidence: 98%

Recurrence of Cardiovascular Events in Patients With Type 2 Diabetes

Giorda

Avogaro

Maggini³

et al. 2008

Diabetes Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…Evidence suggests that these conditions are associated with an increased frequency of cardiovascular events. Indeed, in the subanalysis of the PROactive study, treatment with pioglitazone was found to be significantly reduce the incidence of secondary stroke by 47% in the type 2 diabetes patients with a previous history of stroke 1) . However, that subanalysis also showed that pioglitazone therapy reduced the incidence of the primary outcome by only 6% (p = 0.350) and did not decrease the incidence of primary stroke (HR = 1.06).…”

Section: (A) Primary Outcomementioning

confidence: 99%

“…According to a 4-year follow-up study, risk factors for stroke in patients with type 2 diabetes include an older age, previous history of cardiovascular disease or stroke and microvascular complications 1) . Carotid artery atherosclerosis is another risk factor for stroke, as well as silent cerebral infarction and carotid artery stenosis 2) , in patients with type 2 diabetes, such that the presence of a common carotid intima-media thickness (IMT) of ＞1 mm increases the risk of silent cerebral infarction four times compared to its absence 3) .…”

Section: Introductionmentioning

confidence: 99%

Effects of Pioglitazone on Macrovascular Events in Patients with Type 2 Diabetes Mellitus at High Risk of Stroke: The PROFIT-J Study

Yoshii

Onuma

Yamazaki

et al. 2014

JAT

View full text Add to dashboard Cite

Aim: The present study evaluated the effects of pioglitazone treatment on the incidence of primary cardiovascular events in Japanese subjects with type 2 diabetes mellitus at high risk of stroke. Methods: A prospective, multicenter, randomized, open label, comparative study was conducted among diabetic patients recruited from 50 medical institutions nationwide. A total of 522 patients with hypertension and/or dyslipidemia who had one or more silent cerebral infarcts, advanced carotid atherosclerosis or microalbuminuria at baseline were randomly treated with (n= 254) or without pioglitazone (n = 268) and observed for a medium of 672 days. The hypertension and dyslipidemia were concurrently treated according to the respective treatment guidelines. The primary outcome was the time to the first occurrence of a composite of all-cause death, nonfatal cerebral infarction and nonfatal myocardial infarction. Results: Treatment with pioglitazone resulted in significant reductions in the levels of HbA1c, diastolic blood pressure and LDL-cholesterol and a significant increase in the levels of HDL-cholesterol. The pioglitazone non-users exhibited a significant reduction in the LDL-cholesterol levels alone. Primary events were registered during the study period in nine patients in the pioglitazone group and 10 patients in the non-pioglitazone group. The difference in the cumulative incidence of the primary outcome was not significant between the two groups (1.8% per year). Conclusions: Pioglitazone therapy produces immediate and effective improvements in glycemic control, diastolic blood pressure and lipid profiles. While this study was too underpowered to determine the effects of pioglitazone on the incidence of cardiovascular events, the results indicated that two years of pioglitazone treatment did not produce any statistically significant reductions in the rate of primary cardiovascular events.

show abstract

“…Cukrzyca jest niezależnym czynnikiem ryzyka udaru niedokrwiennego, powodującym 2,5-3,5-krotny wzrost zapadalności na udar w porównaniu z osobami bez cukrzycy [498,499]. W niniejszym opracowaniu omówienie kwestii udarów mózgu i TIA zostało ograniczone do aspektów związanych z chorobą tętnic szyjnych.…”

Section: Choroba Tętnic Szyjnychunclassified