Cited by 103Acute Ischemic Stroke ManagementDiabetes, Cardiovascular Risks, and LipoproteinsNeurological and metabolic disorders

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

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Echouffo-Tcheugui, Justin B, Xu, Haolin, Matsouaka, Roland A, Xian, Ying, Schwamm, Lee H, Smith, Eric E, Bhatt, Deepak L, Hernandez, Adrian F, Heidenreich, Paul A, Fonarow, Gregg C·2018·European Heart Journal

DOI 10.1093/eurheartj/ehy036PMC PMC6031049

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Abstract

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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Authors: Echouffo-Tcheugui, J. B., Xu, H., Matsouaka, R. A., Xian, Y., Schwamm, L. H., Smith, E. E., Bhatt, D. L., Hernandez, A. F., Heidenreich, P. A., & Fonarow, G. C.
Affiliations: Brigham and Women's Hospital (US)
Duke University (US)
Duke Medical Center (US)
Harvard University (US)
University of Calgary (CA)
Stanford Medicine (US)
University of California, Los Angeles (US)
Corresponding author: Fonarow, Gregg C
ORCID: Echouffo-Tcheugui, Justin B
Xu, Haolin
Matsouaka, Roland A
Xian, Ying
Schwamm, Lee H
Smith, Eric E
Bhatt, Deepak L
Hernandez, Adrian F
Heidenreich, Paul A
Fonarow, Gregg C
Venue: European Heart Journal
Publisher: Oxford University Press (OUP)
Published: 2018-02-09
Volume: 39
Issue: 25
Pages: 2376-2386
ISSN: 0195-668X (ISSN-L)
1522-9645
DOI: 10.1093/eurheartj/ehy036
PMC: PMC6031049
OpenAlex: W2789744550
Cited by: 103
References: 56
Citations by year: 2026: 9 · 2025: 18 · 2024: 16 · 2023: 10 · 2022: 15 · 2021: 12 · 2020: 12 · 2019: 5 · 2018: 6
FWCI: 6.83
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/about_us/legal/notices (vor)
Locations: European Heart Journal (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: Guidelines-Stroke
American Heart Association
American Stroke Association
Janssen Pharmaceutical Companies of Johnson & Johnson
Boeringher-Ingelheim
Merck
Bristol-Myers Squib/Sanofi Pharmaceutical Partnership
AHA Pharmaceutical Roundtable
Young Investigator Database Research
National Heart, Lung, and Blood Institute (T32 HL125232)
Topics: Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Clinical Neurology › Neurological and metabolic disorders
Keywords: diabetes mellitus, ischemic stroke, long-term outcomes, all-cause mortality, hospital readmission, heart failure, stroke recurrence, transient ischemic attack, cardiovascular hospitalization, older adults, Get With The Guidelines-Stroke registry, post-discharge follow-up, comorbidities, stroke risk stratification, secondary stroke prevention
MeSH terms: Aged, Aged, 80 and over, Brain Ischemia, Female, Follow-Up Studies, Humans, Male, Registries, Time Factors, United States, Stroke, Diabetes Complications

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

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