Abnormal glucose regulation increases stroke risk in minor ischemic stroke or TIA

Objective:

To investigate whether abnormal glucose regulation contributes to a new stroke in patients with a minor ischemic stroke or TIA.

Methods:

We derived data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 3 groups: patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and normal fasting plasma glucose. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose regulation status and risk of stroke by multivariable Cox regression models adjusted for potential covariates.

Results:

Among 5,135 included patients, 1,587 (30.9%), 409 (8.0%), and 3,139 (61.1%) patients were identified as DM, IFG, and normal glucose, respectively. Compared with normal glucose, IFG (11.0% vs 6.9%; adjusted hazard ratio [adj HR] 1.57, 95% confidence interval [CI] 1.13–2.19) and DM (15.8% vs 6.9%; adj HR 2.38, 95% CI 1.97–2.88) were associated with increased risk of stroke at 3 months after a minor stroke or TIA after adjusted for potential covariates. We found a weak J-shaped association between fasting plasma glucose and risk of stroke with a nadir of 4.9 mmol/L.

Conclusions:

Both IFG and DM were associated with an increased risk of stroke in patients with a minor stroke or TIA.

Clinicaltrials.gov identifier:

NCT00979589.