Abstract WP179: Recurrent Stroke in Minor Ischemic Stroke or TIA With Metabolic Syndrome and/or Diabetes Mellitus

Abstract

Background: We aimed to determine the risk conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent stroke in patients with minor ischemic stroke or transient ischemic attack (TIA) from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. Methods and Results: A total number of 3044 patients were included. Patients were stratified into four groups: neither, METS only, DM only, or both. METS was defined using Chinese Diabetes Society (CDS) and International Diabetes Foundation (IDF) definition. The primary outcome was new stroke (including ischemic and hemorrhagic) at 90 days. Multivariable Cox regression model was used to assess the relationship of METS/DM status to the risk of recurrent stroke adjusted for potential covariates. Using the CDS criteria of METS, 53.2%, 17.2%, 19.8% and 9.8% of patients were diagnosed as neither, METS only, DM only and both conditions, respectively. After 90 days of follow up, there were 299 new strokes (293 ischemic, 6 hemorrhagic). Patients with DM only (16.1% vs 6.8%; adjusted Hazard Ratio = 2.50, 95% confidence interval 1.89-3.39) and both (17.1% vs 6.8%; adjusted HR = 2.76, 95% CI 1.98-3.86) had significantly increased rate of recurrent stroke. No interaction effect of antiplatelet therapy by different METS/DM status for the risk of recurrent stroke (p for interaction =0.82 in the fully adjusted model of CDS) was observed. Using the METS (IDF) criteria demonstrated similar results. Conclusions: Concurrent METS and DM was associated with an increased risk of recurrent stroke in minor stroke and TIA patients.