OBJECTIVES: We used a prospective clinical trial to examine the risks conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent strokes in the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. METHODS: The SPS3 trial enrolled 3,020 patients with lacunar strokes. Participants were stratified into groups of METS only, DM only, both, or neither using American Heart Association/National Heart, Lung, and Blood Institute and World Health Organization guidelines. Annualized event rates of strokes, myocardial infarction (MI), and all-cause mortality were calculated, and hazard ratios (HRs) referencing the “neither” group were computed, controlling for significantly associated baseline characteristics. RESULTS: Among 2,999 participants, 25% had METS only, 6% had DM only, 32% had both conditions, and 37%had neither. Over a median of 3.8 years of follow-up, there were 274 recurrent strokes (240 ischemic, 34 hemorrhagic) and 74 MIs; among the 240 ischemic strokes, 134 (56%) were lacunar. The rates of any recurrent stroke (HR 1.7, 95% confidence interval [CI] 1.3–2.3) or lacunar stroke (HR 2.4, 95% CI 1.5–3.7) were significantly higher for those with concurrent METS and DM compared with those who had neither. Risk of incident MI was higher in participants with DM (HR 2.8, 95% CI 1.1–7.0) or concurrent DM and METS (HR 2.6, 95% CI 1.4–4.9). CONCLUSION: METS and DM were significant comorbid conditions in lacunar stroke patients and they were associated with stroke recurrence. In patients with lacunar infarcts, a vigilant approach to prevent development of DM in those with METS may be a potential strategy to reduce recurrent strokes.
OBJECTIVES: We used a prospective clinical trial to examine the risks conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent strokes in the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. METHODS: The SPS3 trial enrolled 3,020 patients with lacunar strokes. Participants were stratified into groups of METS only, DM only, both, or neither using American Heart Association/National Heart, Lung, and Blood Institute and World Health Organization guidelines. Annualized event rates of strokes, myocardial infarction (MI), and all-cause mortality were calculated, and hazard ratios (HRs) referencing the “neither” group were computed, controlling for significantly associated baseline characteristics. RESULTS: Among 2,999 participants, 25% had METS only, 6% had DM only, 32% had both conditions, and 37%had neither. Over a median of 3.8 years of follow-up, there were 274 recurrent strokes (240 ischemic, 34 hemorrhagic) and 74 MIs; among the 240 ischemic strokes, 134 (56%) were lacunar. The rates of any recurrent stroke (HR 1.7, 95% confidence interval [CI] 1.3–2.3) or lacunar stroke (HR 2.4, 95% CI 1.5–3.7) were significantly higher for those with concurrent METS and DM compared with those who had neither. Risk of incident MI was higher in participants with DM (HR 2.8, 95% CI 1.1–7.0) or concurrent DM and METS (HR 2.6, 95% CI 1.4–4.9). CONCLUSION: METS and DM were significant comorbid conditions in lacunar strokepatients and they were associated with stroke recurrence. In patients with lacunar infarcts, a vigilant approach to prevent development of DM in those with METS may be a potential strategy to reduce recurrent strokes.
Authors: L O Wahlund; F Barkhof; F Fazekas; L Bronge; M Augustin; M Sjögren; A Wallin; H Ader; D Leys; L Pantoni; F Pasquier; T Erkinjuntti; P Scheltens Journal: Stroke Date: 2001-06 Impact factor: 7.914
Authors: Jacqueline M Dekker; Cynthia Girman; Thomas Rhodes; Giel Nijpels; Coen D A Stehouwer; Lex M Bouter; Robert J Heine Journal: Circulation Date: 2005-08-02 Impact factor: 29.690
Authors: Sudhir Kurl; Jari A Laukkanen; Leo Niskanen; David Laaksonen; Juhani Sivenius; Kristiina Nyyssönen; Jukka T Salonen Journal: Stroke Date: 2006-02-09 Impact factor: 7.914
Authors: R Kornowski; G S Mintz; A J Lansky; M K Hong; K M Kent; A D Pichard; L F Satler; J J Popma; T A Bucher; M B Leon Journal: Am J Cardiol Date: 1998-06-01 Impact factor: 2.778
Authors: Tali Cukierman-Yaffe; Leslie A McClure; Thomas Risoli; Jackie Bosch; Mike Sharma; Hertzel C Gerstein; Oscar Benavente Journal: J Clin Endocrinol Metab Date: 2021-03-25 Impact factor: 5.958
Authors: Jie-Hua Su; Ling-Wei Meng; Di Dong; Wen-Yan Zhuo; Jian-Ming Wang; Li-Bin Liu; Yi Qin; Ye Tian; Jie Tian; Zhao-Hui Li Journal: BMC Med Imaging Date: 2020-07-08 Impact factor: 1.930
Authors: Jaurès Kamgang; Francklin Tétinou; Yvan Zolo; Chee Yang Tan; Christian Wambo; Emerancienne J N Fongang; Ulrick Sidney Kanmounye Journal: Neurol Res Int Date: 2021-06-15