Abstract 18995: Association Between Prediabetes and Higher Risk of Mortality Following Acute Ischemic Stroke: A Meta-Analysis

Abstract

Introduction: Prediabetes is known to increase the risk of cardiovascular and cerebrovascular mortality. This study aims to examine the relationship between prediabetes and mortality in patients who have experienced a stroke. Methods: A systematic search was conducted in PubMed/Medline, SCOPUS, and Google Scholar databases until May 2023 to identify relevant articles reporting on the association of prediabetes with ischemic stroke mortality. A random-effects model was used to calculate odds ratios (OR), heterogeneity was assessed using I 2 statistics, and sensitivity analysis was performed using the leave-one-out method. Results: Our final analysis contained 11 studies which included 84,833 prediabetic patients with a mean follow-up time of 20.9 months. The prediabetes cohort comprised patients of an average age of 67 years from various countries, including Korea, Italy, Japan, China, Spain, and the Netherlands. Initially, the unadjusted analysis showed no significant association between prediabetes and post-stroke mortality (OR 1.06, 95% CI 0.51-2.19) with high heterogeneity (I2=94.7%, P<0.01). However, after adjusting for baseline characteristics and comorbidities, the prediabetes cohort exhibited a significantly higher risk of post-stroke mortality (adjusted OR 1.68, 95% CI 1.29-2.19) with moderate heterogeneity (I2=49.45%, P=0.03). Subgroup analysis by country revealed higher odds of mortality in Korea, Italy, Spain, Japan, and the Netherlands. However, statistical significance was not reached for each subgroup, indicating the need for larger studies. Conclusions: Our findings suggest that prediabetes is associated with a nearly 68% higher risk of mortality following a stroke. This warrants more prospective studies with prediabetes to validate these findings.