Incidence and risk factors for stroke in type 2 diabetic patients the DAI study
Type 2 diabetes mellitus is a strong predictor of cerebrovascular disease, yet few studies have assessed the incidence of stroke and the role of other risk factors in unselected type 2 diabetes mellitus populations. We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97...
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| creator | GIORDA, Carlo Bruno AVOGARO, Angelo MAGGINI, Marina LOMBARDO, Flavia MANNUCCI, Edoardo TURCO, Salvatore ALEGIANI, Stefania Spila RASCHETTI, Roberto VELUSSI, Mario FERRANNINI, Ele |
| description | Type 2 diabetes mellitus is a strong predictor of cerebrovascular disease, yet few studies have assessed the incidence of stroke and the role of other risk factors in unselected type 2 diabetes mellitus populations.
We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97 years, with and without a history of cardiovascular disease at enrollment, and we estimated the incidence of stroke and the hazards ratios with respect to clinical variables.
During a 4-year follow-up, 296 incident stroke events were recorded. In persons with no history of cardiovascular disease, the age-standardized incidence of stroke (per 1000 person-years) was 5.5 (95% confidence interval, 4.2 to 6.8) in men and 6.3 (95% confidence interval, 4.5 to 8.2) in women. In persons with a history of cardiovascular disease, it was 13.7 (95% confidence interval, 7.5 to 19.8) in men and 10.8 (95% confidence interval, 7.3 to 14.4) in women. The hazards ratios of stroke incidence varied according to age, sex, and history of cardiovascular disease. Among men with no history, HbA1c and smoking were predictors of stroke. Among patients with a history, the risk factors were, in men, therapy with insulin plus oral agents, treated high total cholesterol and low HDL cholesterol, whereas in women microvascular complications were a risk factor. Previous stroke was a strong predictor of stroke in both sexes.
Age and previous stroke are the main predictors of stroke in diabetes. The combined role of Hba1c, microvascular complications, low HDL cholesterol, and treatment with insulin plus oral agents highlights the importance of diabetic history and clinical background in the development of stroke. |
| doi_str_mv | 10.1161/01.STR.0000260100.71665.2f |
| format | Article |
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We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97 years, with and without a history of cardiovascular disease at enrollment, and we estimated the incidence of stroke and the hazards ratios with respect to clinical variables.
During a 4-year follow-up, 296 incident stroke events were recorded. In persons with no history of cardiovascular disease, the age-standardized incidence of stroke (per 1000 person-years) was 5.5 (95% confidence interval, 4.2 to 6.8) in men and 6.3 (95% confidence interval, 4.5 to 8.2) in women. In persons with a history of cardiovascular disease, it was 13.7 (95% confidence interval, 7.5 to 19.8) in men and 10.8 (95% confidence interval, 7.3 to 14.4) in women. The hazards ratios of stroke incidence varied according to age, sex, and history of cardiovascular disease. Among men with no history, HbA1c and smoking were predictors of stroke. Among patients with a history, the risk factors were, in men, therapy with insulin plus oral agents, treated high total cholesterol and low HDL cholesterol, whereas in women microvascular complications were a risk factor. Previous stroke was a strong predictor of stroke in both sexes.
Age and previous stroke are the main predictors of stroke in diabetes. The combined role of Hba1c, microvascular complications, low HDL cholesterol, and treatment with insulin plus oral agents highlights the importance of diabetic history and clinical background in the development of stroke.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000260100.71665.2f</identifier><identifier>PMID: 17332448</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood. Blood coagulation. Reticuloendothelial system ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - physiopathology ; Cholesterol, HDL - blood ; Cohort Studies ; Comorbidity ; Diabetes Complications - epidemiology ; Diabetes Complications - physiopathology ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - physiopathology ; Female ; Follow-Up Studies ; Glycated Hemoglobin A ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Hemoglobins - metabolism ; Humans ; Hypoglycemic Agents - therapeutic use ; Incidence ; Insulin - therapeutic use ; Italy - epidemiology ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Prevalence ; Prospective Studies ; Risk Factors ; Sex Distribution ; Stroke - epidemiology ; Stroke - physiopathology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2007-04, Vol.38 (4), p.1154-1160</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c357t-fcb02a1d71b0fc264916429a02a1be9f57ef5b90779e57df4ff47ed6b7d2f3ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,3688,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18639022$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17332448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GIORDA, Carlo Bruno</creatorcontrib><creatorcontrib>AVOGARO, Angelo</creatorcontrib><creatorcontrib>MAGGINI, Marina</creatorcontrib><creatorcontrib>LOMBARDO, Flavia</creatorcontrib><creatorcontrib>MANNUCCI, Edoardo</creatorcontrib><creatorcontrib>TURCO, Salvatore</creatorcontrib><creatorcontrib>ALEGIANI, Stefania Spila</creatorcontrib><creatorcontrib>RASCHETTI, Roberto</creatorcontrib><creatorcontrib>VELUSSI, Mario</creatorcontrib><creatorcontrib>FERRANNINI, Ele</creatorcontrib><creatorcontrib>DAI Study Group</creatorcontrib><creatorcontrib>The DAI Study Group</creatorcontrib><title>Incidence and risk factors for stroke in type 2 diabetic patients the DAI study</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Type 2 diabetes mellitus is a strong predictor of cerebrovascular disease, yet few studies have assessed the incidence of stroke and the role of other risk factors in unselected type 2 diabetes mellitus populations.
We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97 years, with and without a history of cardiovascular disease at enrollment, and we estimated the incidence of stroke and the hazards ratios with respect to clinical variables.
During a 4-year follow-up, 296 incident stroke events were recorded. In persons with no history of cardiovascular disease, the age-standardized incidence of stroke (per 1000 person-years) was 5.5 (95% confidence interval, 4.2 to 6.8) in men and 6.3 (95% confidence interval, 4.5 to 8.2) in women. In persons with a history of cardiovascular disease, it was 13.7 (95% confidence interval, 7.5 to 19.8) in men and 10.8 (95% confidence interval, 7.3 to 14.4) in women. The hazards ratios of stroke incidence varied according to age, sex, and history of cardiovascular disease. Among men with no history, HbA1c and smoking were predictors of stroke. Among patients with a history, the risk factors were, in men, therapy with insulin plus oral agents, treated high total cholesterol and low HDL cholesterol, whereas in women microvascular complications were a risk factor. Previous stroke was a strong predictor of stroke in both sexes.
Age and previous stroke are the main predictors of stroke in diabetes. The combined role of Hba1c, microvascular complications, low HDL cholesterol, and treatment with insulin plus oral agents highlights the importance of diabetic history and clinical background in the development of stroke.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood coagulation. Reticuloendothelial system</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Cholesterol, HDL - blood</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Diabetes Complications - epidemiology</subject><subject>Diabetes Complications - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin A</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Insulin - therapeutic use</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pharmacology. Drug treatments</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sex Distribution</subject><subject>Stroke - epidemiology</subject><subject>Stroke - physiopathology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0MtKAzEUgOEgiq3VV5Ag6G7G3CZp3Em9FQoFreuQSU5wtJ2pSbro2zvVQpdmEwhfksOP0BUlJaWS3hJavi1eS9IvJgklpFRUyqpk4QgNacVEISQbH6MhIVwXTGg9QGcpfe48H1enaEAV50yI8RDNp61rPLQOsG09jk36wsG63MWEQxdxyrH7Aty0OG_XgBn2ja0hNw6vbW6gzQnnD8AP99Oebvz2HJ0Eu0xwsd9H6P3pcTF5KWbz5-nkflY4XqlcBFcTZqlXtCbBMSk0lYJpuzusQYdKQahqTZTSUCkfRAhCgZe18ixwCHyEbv7eXcfuewMpm1WTHCyXtoVuk4winArFxL-Q9Q0FF1UP7_6gi11KEYJZx2Zl49ZQYnbdDaGm724O3c1vd8N241zuf9nUK_CHq_vQPbjeA5ucXYZo--7p4MaSa8IY_wHjmotz</recordid><startdate>20070401</startdate><enddate>20070401</enddate><creator>GIORDA, Carlo Bruno</creator><creator>AVOGARO, Angelo</creator><creator>MAGGINI, Marina</creator><creator>LOMBARDO, Flavia</creator><creator>MANNUCCI, Edoardo</creator><creator>TURCO, Salvatore</creator><creator>ALEGIANI, Stefania Spila</creator><creator>RASCHETTI, Roberto</creator><creator>VELUSSI, Mario</creator><creator>FERRANNINI, Ele</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20070401</creationdate><title>Incidence and risk factors for stroke in type 2 diabetic patients the DAI study</title><author>GIORDA, Carlo Bruno ; AVOGARO, Angelo ; MAGGINI, Marina ; LOMBARDO, Flavia ; MANNUCCI, Edoardo ; TURCO, Salvatore ; ALEGIANI, Stefania Spila ; RASCHETTI, Roberto ; VELUSSI, Mario ; FERRANNINI, Ele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-fcb02a1d71b0fc264916429a02a1be9f57ef5b90779e57df4ff47ed6b7d2f3ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood coagulation. Reticuloendothelial system</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Cholesterol, HDL - blood</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Diabetes Complications - epidemiology</topic><topic>Diabetes Complications - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glycated Hemoglobin A</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Insulin - therapeutic use</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pharmacology. Drug treatments</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>Stroke - epidemiology</topic><topic>Stroke - physiopathology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GIORDA, Carlo Bruno</creatorcontrib><creatorcontrib>AVOGARO, Angelo</creatorcontrib><creatorcontrib>MAGGINI, Marina</creatorcontrib><creatorcontrib>LOMBARDO, Flavia</creatorcontrib><creatorcontrib>MANNUCCI, Edoardo</creatorcontrib><creatorcontrib>TURCO, Salvatore</creatorcontrib><creatorcontrib>ALEGIANI, Stefania Spila</creatorcontrib><creatorcontrib>RASCHETTI, Roberto</creatorcontrib><creatorcontrib>VELUSSI, Mario</creatorcontrib><creatorcontrib>FERRANNINI, Ele</creatorcontrib><creatorcontrib>DAI Study Group</creatorcontrib><creatorcontrib>The DAI Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GIORDA, Carlo Bruno</au><au>AVOGARO, Angelo</au><au>MAGGINI, Marina</au><au>LOMBARDO, Flavia</au><au>MANNUCCI, Edoardo</au><au>TURCO, Salvatore</au><au>ALEGIANI, Stefania Spila</au><au>RASCHETTI, Roberto</au><au>VELUSSI, Mario</au><au>FERRANNINI, Ele</au><aucorp>DAI Study Group</aucorp><aucorp>The DAI Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and risk factors for stroke in type 2 diabetic patients the DAI study</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2007-04-01</date><risdate>2007</risdate><volume>38</volume><issue>4</issue><spage>1154</spage><epage>1160</epage><pages>1154-1160</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Type 2 diabetes mellitus is a strong predictor of cerebrovascular disease, yet few studies have assessed the incidence of stroke and the role of other risk factors in unselected type 2 diabetes mellitus populations.
We prospectively followed-up 14,432 type 2 diabetes mellitus patients, aged 40 to 97 years, with and without a history of cardiovascular disease at enrollment, and we estimated the incidence of stroke and the hazards ratios with respect to clinical variables.
During a 4-year follow-up, 296 incident stroke events were recorded. In persons with no history of cardiovascular disease, the age-standardized incidence of stroke (per 1000 person-years) was 5.5 (95% confidence interval, 4.2 to 6.8) in men and 6.3 (95% confidence interval, 4.5 to 8.2) in women. In persons with a history of cardiovascular disease, it was 13.7 (95% confidence interval, 7.5 to 19.8) in men and 10.8 (95% confidence interval, 7.3 to 14.4) in women. The hazards ratios of stroke incidence varied according to age, sex, and history of cardiovascular disease. Among men with no history, HbA1c and smoking were predictors of stroke. Among patients with a history, the risk factors were, in men, therapy with insulin plus oral agents, treated high total cholesterol and low HDL cholesterol, whereas in women microvascular complications were a risk factor. Previous stroke was a strong predictor of stroke in both sexes.
Age and previous stroke are the main predictors of stroke in diabetes. The combined role of Hba1c, microvascular complications, low HDL cholesterol, and treatment with insulin plus oral agents highlights the importance of diabetic history and clinical background in the development of stroke.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17332448</pmid><doi>10.1161/01.STR.0000260100.71665.2f</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Blood. Blood coagulation. Reticuloendothelial system Cardiovascular Diseases - epidemiology Cardiovascular Diseases - physiopathology Cholesterol, HDL - blood Cohort Studies Comorbidity Diabetes Complications - epidemiology Diabetes Complications - physiopathology Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - physiopathology Female Follow-Up Studies Glycated Hemoglobin A Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Hemoglobins - metabolism Humans Hypoglycemic Agents - therapeutic use Incidence Insulin - therapeutic use Italy - epidemiology Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Pharmacology. Drug treatments Predictive Value of Tests Prevalence Prospective Studies Risk Factors Sex Distribution Stroke - epidemiology Stroke - physiopathology Vascular diseases and vascular malformations of the nervous system |
| title | Incidence and risk factors for stroke in type 2 diabetic patients the DAI study |
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