BACKGROUND: The prognosis in ischemic stroke is poor in diabetic patients. However, scant research has so far been done on the predisposing factors associated with poor outcomes. METHODS: We prospectively investigated the background characteristics and prognosis at 3 months in 241 consecutive diabetic patients having their first ischemic stroke (153 males, 88 females, mean age ± SD, 71 ± 10 years). Poor functional outcome was defined as modified Rankin scale ≥ 3 at 3 months after onset. RESULTS: Univariate analysis showed that age, dementia, initial National Institutes of Health Stroke Scale (NIHSS) score, systolic blood pressure on admission, proteinuria, stroke subtype, and prior use of angiotensin receptor blocker (ARB) were significantly related to an outcome at 3 months after onset. A multivariate logistic regression analysis showed that age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01 to 1.13, p=0.017, per 1-year increase), NIHSS score (OR 1.22, 95% CI 1.12 to 1.35, p<0.001, per 1-score increase), and proteinuria (OR 4.22, 95% CI 1.71 to 10.92, p=0.002) were significantly and independently associated with poor clinical outcome after ischemic stroke in diabetic patients. Conversely, prior use of ARB (OR 0.28, 95% CI 0.09 to 0.79, p=0.023) was associated with a better outcome. CONCLUSIONS: In diabetic patients, proteinuria was independently associated with a poor clinical outcome after ischemic stroke, whereas the prior use of ARB appeared to be beneficial.
BACKGROUND: The prognosis in ischemic stroke is poor in diabeticpatients. However, scant research has so far been done on the predisposing factors associated with poor outcomes. METHODS: We prospectively investigated the background characteristics and prognosis at 3 months in 241 consecutive diabeticpatients having their first ischemic stroke (153 males, 88 females, mean age ± SD, 71 ± 10 years). Poor functional outcome was defined as modified Rankin scale ≥ 3 at 3 months after onset. RESULTS: Univariate analysis showed that age, dementia, initial National Institutes of Health Stroke Scale (NIHSS) score, systolic blood pressure on admission, proteinuria, stroke subtype, and prior use of angiotensin receptor blocker (ARB) were significantly related to an outcome at 3 months after onset. A multivariate logistic regression analysis showed that age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01 to 1.13, p=0.017, per 1-year increase), NIHSS score (OR 1.22, 95% CI 1.12 to 1.35, p<0.001, per 1-score increase), and proteinuria (OR 4.22, 95% CI 1.71 to 10.92, p=0.002) were significantly and independently associated with poor clinical outcome after ischemic stroke in diabeticpatients. Conversely, prior use of ARB (OR 0.28, 95% CI 0.09 to 0.79, p=0.023) was associated with a better outcome. CONCLUSIONS: In diabeticpatients, proteinuria was independently associated with a poor clinical outcome after ischemic stroke, whereas the prior use of ARB appeared to be beneficial.