Abstract
BackgroundDiabetes and dyslipidemia are significantly associated with stroke recurrence, yet the evidence for this relationship is conflicting. Consequently, the parameters in the glucose and lipid profiles may inform us regarding their relationship with stroke recurrence, thus enhancing the physicians’ clinical decision-making.AimThis study sought to investigate whether glucose and lipid profiles could prognosticate stroke recurrence in Malaysia.MethodsWe conducted a retrospective hospital-based study where we analyzed the first-ever stroke cases regarding about which the Malaysia National Stroke Registry was informed between 2009 and 2017, that fulfilled this study’s criteria, and that were followed for stroke recurrence. Using the Cox proportional hazard regression analysis, we estimated the adjusted hazard ratios (HRs), which reflected the prognostic effect of the primary variables (i.e., glucose and lipid profiles on the first-stroke admission) on stroke recurrence.ResultsAmong the 8,576 first-ever stroke patients, 394 (4.6%) experienced a subsequent first stroke recurrence event. The prognostic effect measured by univariable Cox regression showed that, when unadjusted, ten variables have prognostic value with regards to stroke recurrence. A multivariable regression analysis revealed that glucose was not a significant prognostic factor (adjusted HR 1.28; 95% CI [1.00–1.65]), while triglyceride level was the only parameter in the lipid profile found to have an independent prognostication concerning stroke recurrence (adjusted HR: 1.28 to 1.36).ConclusionsTriglyceride could independently prognosticate stroke recurrence, which suggests the role of physicians in intervening hypertriglyceridemia. In line with previous recommendations, we call for further investigations in first-ever stroke patients with impaired glucose and lipid profiles and suggest a need for interventions in these patients.
Highlights
IntroductionStroke recurrence refers to ‘‘a new neurologic deficit, including ischemic (or transient ischemic attack) or hemorrhagic stroke [that is] associated with rehospitalization’’ (Mi et al, 2012)
Stroke recurrence refers to ‘‘a new neurologic deficit, including ischemic or hemorrhagic stroke [that is] associated with rehospitalization’’ (Mi et al, 2012)
We have analyzed the data of 8,576 first-ever stroke patients, all of whom were enrolled in the Malaysian National Stroke Registry
Summary
Stroke recurrence refers to ‘‘a new neurologic deficit, including ischemic (or transient ischemic attack) or hemorrhagic stroke [that is] associated with rehospitalization’’ (Mi et al, 2012). The role of impaired glucose and lipid metabolism in prognosticating stroke recurrence is worth exploring to enhance secondary stroke prevention (Awada, 2011). Aim. This study sought to investigate whether glucose and lipid profiles could prognosticate stroke recurrence in Malaysia. Using the Cox proportional hazard regression analysis, we estimated the adjusted hazard ratios (HRs), which reflected the prognostic effect of the primary variables (i.e., glucose and lipid profiles on the first-stroke admission) on stroke recurrence. A multivariable regression analysis revealed that glucose was not a significant prognostic factor (adjusted HR 1.28; 95% CI [1.00–1.65]), while triglyceride level was the only parameter in the lipid profile found to have an independent prognostication concerning stroke recurrence (adjusted HR: 1.28 to 1.36). In line with previous recommendations, we call for further investigations in first-ever stroke patients with impaired glucose and lipid profiles and suggest a need for interventions in these patients
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