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Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke.

Publication ,  Journal Article
Echouffo-Tcheugui, JB; Xu, H; Matsouaka, RA; Xian, Y; Schwamm, LH; Smith, EE; Bhatt, DL; Hernandez, AF; Heidenreich, PA; Fonarow, GC
Published in: Eur Heart J
July 1, 2018

AIMS: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. METHODS AND RESULTS: Patients aged ≥65 years (n = 409 060) in Get With The Guidelines-Stroke (nationwide registry of stroke patients from 1690 sites in the USA) were followed for 3 years post-discharge. The outcomes of interest were mortality, cardiovascular and non-cardiovascular hospitalizations, heart failure (HF), and recurrence of IS/transient ischaemic attack (TIA). Patients with diabetes (29.6%) were younger and had more comorbidities. At 3 years post-discharge after IS, diabetes was associated with higher risks of adverse outcomes: all-cause mortality [cumulative incidence 46.0% vs. 44.2%, absolute difference (AD) 1.8%; adjusted hazard ratio (aHR) 1.24, 95% confidence interval 1.23-1.25], all-cause readmission (71.3% vs. 63.7%, AD 7.6%; aHR 1.22, 1.21-1.23), composite of mortality and all-cause readmission (84.1% vs. 79.3%, AD 4.8%; aHR 1.21, 1.20-1.22), composite of mortality and cardiovascular readmission (69.5% vs. 64.3%, AD 5.2%; aHR 1.19, 1.18-1.20), IS/TIA readmission (15.9% vs. 13.3%, AD 2.6%; aHR 1.18, 1.16-1.20), HF readmission (10.3% vs. 6.4%, AD 3.9%; aHR 1.60, 1.56-1.64), non-cardiovascular readmission (58.3% vs. 50.3%, AD 8.0%; aHR 1.28, 1.26-1.29), and non-IS/TIA readmission (67.6% vs. 59.7%, AD 7.9%; aHR 1.23, 1.22-1.25). Accounting for the initial severity of stroke using the National Institute of Health Stroke Scale as well as using propensity score matching method as a sensitivity analysis, did not modify the results. CONCLUSION: Among older IS patients diabetes was associated with increased risks of death, cardiovascular and non-cardiovascular hospitalizations, HF, and IS/TIA recurrence.

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Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 1, 2018

Volume

39

Issue

25

Start / End Page

2376 / 2386

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Stroke
  • Registries
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Diabetes Complications
  • Cardiovascular System & Hematology
 

Citation

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Echouffo-Tcheugui, J. B., Xu, H., Matsouaka, R. A., Xian, Y., Schwamm, L. H., Smith, E. E., … Fonarow, G. C. (2018). Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. Eur Heart J, 39(25), 2376–2386. https://doi.org/10.1093/eurheartj/ehy036
Echouffo-Tcheugui, Justin B., Haolin Xu, Roland A. Matsouaka, Ying Xian, Lee H. Schwamm, Eric E. Smith, Deepak L. Bhatt, Adrian F. Hernandez, Paul A. Heidenreich, and Gregg C. Fonarow. “Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke.Eur Heart J 39, no. 25 (July 1, 2018): 2376–86. https://doi.org/10.1093/eurheartj/ehy036.
Echouffo-Tcheugui JB, Xu H, Matsouaka RA, Xian Y, Schwamm LH, Smith EE, et al. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. Eur Heart J. 2018 Jul 1;39(25):2376–86.
Echouffo-Tcheugui, Justin B., et al. “Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke.Eur Heart J, vol. 39, no. 25, July 2018, pp. 2376–86. Pubmed, doi:10.1093/eurheartj/ehy036.
Echouffo-Tcheugui JB, Xu H, Matsouaka RA, Xian Y, Schwamm LH, Smith EE, Bhatt DL, Hernandez AF, Heidenreich PA, Fonarow GC. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. Eur Heart J. 2018 Jul 1;39(25):2376–2386.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 1, 2018

Volume

39

Issue

25

Start / End Page

2376 / 2386

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Stroke
  • Registries
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Diabetes Complications
  • Cardiovascular System & Hematology