S H Read1, D A McAllister2, H M Colhoun3, B Farran3, C Fischbacher4, J J Kerssens4, G P Leese5, R S Lindsay6, R J McCrimmon7, S McGurnaghan3, S Philip8, N Sattar9, S H Wild1. 1. Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK. 2. Institutes of Health and Wellbeing, University of Glasgow, Glasgow, UK. 3. Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. 4. Information Services Division, NHS National Services, Edinburgh, UK. 5. Department of Diabetes and Endocrinology, University of Dundee, Dundee, UK. 6. Institutes of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. 7. Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK. 8. Department of Diabetes and Endocrinology, NHS Grampian, Aberdeen, UK. 9. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Abstract
AIM: To describe trends in first ischaemic stroke incidence and case fatality in adults with and without a diagnosis of Type 2 diabetes prior to their ischaemic stroke event in Scotland between 2004 and 2013. METHODS: Using population-wide hospital admission, death and diabetes datasets, we conducted a retrospective cohort study. Negative binomial and logistic regression models were used to calculate year-specific incidence and case-fatality rates for people with Type 2 diabetes and for people without diabetes. RESULTS: During 41.0 million person-years of follow-up there were 69 757 ischaemic stroke events. Type 2 diabetes prevalence among patients who experienced ischaemic stroke increased from 13.5% to 20.3% between 2004 and 2013. Stroke incidence rates declined by 2.7% (95% CI 2.4, 3.0) annually for people with and without diabetes [diabetes/year interaction: rate ratio 0.99 (95% CI 0.98, 1.01)]. Type 2 diabetes was associated with an increased risk of ischaemic stroke in men [rate ratio 1.23 (95% CI 1.17, 1.30)] and women [rate ratio 1.41 (95% CI 1.35, 1.48)]. Case-fatality rates were 14.2% and 12.7% in people with Type 2 diabetes and without diabetes, respectively. Case fatality declined by 3.5% (95% CI 2.7, 4.5) annually [diabetes/year interaction: odds ratio 1.01 (95% CI 0.98, 1.02)]. CONCLUSIONS: Ischaemic stroke incidence declined no faster in people with a diagnosis of Type 2 diabetes than in people without diabetes. Increasing prevalence of Type 2 diabetes among stroke patients may mean that declines in case fatality over time will be less marked in the future.
AIM: To describe trends in first ischaemic stroke incidence and case fatality in adults with and without a diagnosis of Type 2 diabetes prior to their ischaemic stroke event in Scotland between 2004 and 2013. METHODS: Using population-wide hospital admission, death and diabetes datasets, we conducted a retrospective cohort study. Negative binomial and logistic regression models were used to calculate year-specific incidence and case-fatality rates for people with Type 2 diabetes and for people without diabetes. RESULTS: During 41.0 million person-years of follow-up there were 69 757 ischaemic stroke events. Type 2 diabetes prevalence among patients who experienced ischaemic stroke increased from 13.5% to 20.3% between 2004 and 2013. Stroke incidence rates declined by 2.7% (95% CI 2.4, 3.0) annually for people with and without diabetes [diabetes/year interaction: rate ratio 0.99 (95% CI 0.98, 1.01)]. Type 2 diabetes was associated with an increased risk of ischaemic stroke in men [rate ratio 1.23 (95% CI 1.17, 1.30)] and women [rate ratio 1.41 (95% CI 1.35, 1.48)]. Case-fatality rates were 14.2% and 12.7% in people with Type 2 diabetes and without diabetes, respectively. Case fatality declined by 3.5% (95% CI 2.7, 4.5) annually [diabetes/year interaction: odds ratio 1.01 (95% CI 0.98, 1.02)]. CONCLUSIONS: Ischaemic stroke incidence declined no faster in people with a diagnosis of Type 2 diabetes than in people without diabetes. Increasing prevalence of Type 2 diabetes among stroke patients may mean that declines in case fatality over time will be less marked in the future.
Authors: David A McAllister; Stephanie H Read; Jan Kerssens; Shona Livingstone; Stuart McGurnaghan; Pardeep Jhund; John Petrie; Naveed Sattar; Colin Fischbacher; Soren Lund Kristensen; John McMurray; Helen M Colhoun; Sarah H Wild Journal: Circulation Date: 2018-12-11 Impact factor: 29.690
Authors: S McGurnaghan; L A K Blackbourn; E Mocevic; U Haagen Panton; R J McCrimmon; N Sattar; S Wild; H M Colhoun Journal: Diabet Med Date: 2018-10-10 Impact factor: 4.359