Diabetes mellitus and ischemic stroke in the young Clinical features and long-term prognosis

被引:42
作者
Putaala, J. [1 ]
Liebkind, R. [1 ]
Gordin, D. [2 ,3 ]
Thorn, L. M. [2 ,3 ]
Haapaniemi, E. [1 ]
Forsblom, C. [2 ,3 ]
Groop, P. -H. [2 ,3 ]
Kaste, M. [1 ]
Tatlisumak, T. [1 ]
机构
[1] Univ Helsinki, Cent Hosp, Dept Neurol, FIN-00290 Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Div Nephrol, Dept Med, FIN-00290 Helsinki, Finland
[3] Biomedicum Helsinki, Folkhalsan Res Ctr, Folkhalsan Inst Genet, Helsinki, Finland
关键词
RISK-FACTOR; MORTALITY; ASSOCIATION; PREDICTORS; DISEASE; ADULTS; PREVENTION; GUIDELINE; CHILDREN; SUBTYPES;
D O I
10.1212/WNL.0b013e31821cccc2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To compare risk factors, stroke characteristics, and long-term prognosis between nondiabetic young ischemic stroke patients and similar patients having either type 1 diabetes mellitus (T1D) or type 2 diabetes mellitus (T2D) to provide information for patient management, counseling, and future research in these patient groups. Methods: Our database comprised 1,008 consecutive patients aged 15 to 49 with first-ever ischemic stroke from 1994 to 2007. Primary outcome measures were 1) nonfatal or fatal recurrent ischemic stroke and 2) composite vascular endpoint (myocardial infarction, any stroke, revascularization, or vascular death). Results: Compared with nondiabetic stroke patients (n = 904), patients with T1D (44) or T2D (60) were more likely to have hypertension and stroke attributable to small-vessel disease (SVD). In addition, when compared with nondiabetic patients, those with T1D more frequently had coronary heart disease and peripheral arterial disease (PAD) and those with T2D more often had obesity, PAD, history of TIA, and stroke attributable to large-artery atherosclerosis, and T2D patients were also more likely to be older and male than were the nondiabetic patients. Mean follow-up in survivors was 9.0 (+/- 3.8) years. Cumulative recurrent ischemic stroke rate at 10 years was 40.9% for T1D (14 events), 29.7% for T2D (15), and 12.0% for nondiabetic patients (94). Corresponding rates for the composite vascular endpoint were 65.1% for T1D (25), 46.9% for T2D (28), and 19.3% for nondiabetic patients (153). Conclusions: Our findings suggest that ischemic stroke patients with T1D or T2D exhibit a distinct risk-factor and etiologic profile and a worse vascular prognosis than do nondiabetic patients. Neurology (R) 2011;76:1831-1837
引用
收藏
页码:1831 / 1837
页数:7
相关论文
共 22 条
  • [21] Type 1 diabetes as a risk factor for stroke in men and women aged 15-49: a nationwide study from Sweden
    Sundquist, K.
    Li, X.
    [J]. DIABETIC MEDICINE, 2006, 23 (11) : 1261 - 1267
  • [22] Cerebral white matter lesions, retinopathy, and incident clinical stroke
    Wong, TY
    Klein, R
    Sharrett, AR
    Couper, DJ
    Klein, BEK
    Liao, DP
    Hubbard, LD
    Mosley, TH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (01): : 67 - 74