Skip to main content
Journal cover image

Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.

Publication ,  Journal Article
Mac Grory, B; Piccini, JP; Yaghi, S; Poli, S; De Havenon, A; Rostanski, SK; Weiss, M; Xian, Y; Johnston, SC; Feng, W
Published in: J Am Heart Assoc
February 2022

Background One-quarter of all strokes are subsequent events. It is not known whether higher levels of blood glucose are associated with an increased risk of subsequent stroke after high-risk transient ischemic attack or minor ischemic stroke. Methods and Results We performed a secondary analysis of the POINT (Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial to evaluate the relationship between serum glucose hyperglycemia (≥180 mg/dL) versus normoglycemia (<180 mg/dL) before enrollment in the trial and outcomes at 90 days. The primary end point was subsequent ischemic stroke modeled by a multivariable Cox model with adjustment for age, sex, race, ethnicity, study treatment assignment, index event, and key comorbidities. Of 4878 patients included in this study, 267 had a recurrent stroke. There was a higher hazard of subsequent stroke in patients with hyperglycemia compared with normoglycemia (adjusted hazard ratio [HR], 1.50 [95% CI, 1.05-2.14]). Treatment with dual antiplatelet therapy was not associated with a reduced hazard of subsequent stroke in patients with hyperglycemia (HR, 1.18 [95% CI, 0.69-2.03]), though the wide confidence interval does not exclude a treatment effect. When modeled as a continuous variable, there was evidence of a nonlinear association between serum glucose and the hazard of subsequent stroke (P<0.001). Conclusions Hyperglycemia on presentation is associated with an increased risk of subsequent ischemic stroke after high-risk transient ischemic attack or minor stroke. A rapid, simple assay of serum glucose may be a useful biomarker to identify patients at particularly high risk of subsequent ischemic stroke. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT0099102.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

February 2022

Volume

11

Issue

3

Start / End Page

e023223

Location

England

Related Subject Headings

  • Stroke
  • Recurrence
  • Platelet Aggregation Inhibitors
  • Ischemic Stroke
  • Ischemic Attack, Transient
  • Hyperglycemia
  • Humans
  • Clopidogrel
  • Blood Glucose
  • Aspirin
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mac Grory, B., Piccini, J. P., Yaghi, S., Poli, S., De Havenon, A., Rostanski, S. K., … Feng, W. (2022). Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial. J Am Heart Assoc, 11(3), e023223. https://doi.org/10.1161/JAHA.121.023223
Mac Grory, Brian, Jonathan P. Piccini, Shadi Yaghi, Sven Poli, Adam De Havenon, Sara K. Rostanski, Martin Weiss, Ying Xian, S Claiborne Johnston, and Wuwei Feng. “Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.J Am Heart Assoc 11, no. 3 (February 2022): e023223. https://doi.org/10.1161/JAHA.121.023223.
Mac Grory B, Piccini JP, Yaghi S, Poli S, De Havenon A, Rostanski SK, et al. Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial. J Am Heart Assoc. 2022 Feb;11(3):e023223.
Mac Grory, Brian, et al. “Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.J Am Heart Assoc, vol. 11, no. 3, Feb. 2022, p. e023223. Pubmed, doi:10.1161/JAHA.121.023223.
Mac Grory B, Piccini JP, Yaghi S, Poli S, De Havenon A, Rostanski SK, Weiss M, Xian Y, Johnston SC, Feng W. Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial. J Am Heart Assoc. 2022 Feb;11(3):e023223.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

February 2022

Volume

11

Issue

3

Start / End Page

e023223

Location

England

Related Subject Headings

  • Stroke
  • Recurrence
  • Platelet Aggregation Inhibitors
  • Ischemic Stroke
  • Ischemic Attack, Transient
  • Hyperglycemia
  • Humans
  • Clopidogrel
  • Blood Glucose
  • Aspirin