Impaired glucose metabolism and the risk of vascular events and mortality after ischemic stroke: A systematic review and meta-analysis
Authors' conclusion
DM is associated with a 56% increased relative risk of death after IS and TIA. Risk estimates regarding recurrent events are similarly high between prediabetes and DM, indicating high cardiovascular risk burden already in precursor stages of DM. There was a high heterogeneity across most outcomes.
Study context
- Population
- Patients with ischemic stroke (IS) or transient ischemic attack (TIA)159 studies
- Comparison
- Impaired glucose metabolism vs normoglycemia
- Outcome
- Recurrent stroke, cardiac events, cardiovascular and all-cause mortality and composite of vascular outcomes
Methodological detailsrandom-effects meta-analysis, covariate adjusted outcomes, 67% of studies had low risk of bias, Search of PubMed, Embase, Cochrane Library on 21st March 2024; 10,974 studies identified
- Random-effects meta-analysis
- Covariate adjusted outcomes
- 67% of studies had low risk of bias
- Search of PubMed, Embase, Cochrane Library on 21st March 2024; 10,974 studies identified
Pooled result
As reported in the abstract
Recurrent stroke, cardiac events, all-cause mortality and composite vascular outcomes
Each group vs normoglycemiaPooled hazard ratio (95% CI)
DMcomposite events; I2 = 88%
1.58(1.34–1.85)
DMrecurrent stroke; I2 = 92%
1.42(1.29–1.56)
DMcardiac events; I2 = 0%
1.55(1.50–1.61)
DMall-cause mortality; I2 = 99%
1.56(1.34–1.82)
Prediabetescomposite events; I2 = 0%
1.50(1.15–1.96)
Prediabetesrecurrent stroke; I2 = 0
1.50(1.18–1.91)
Prediabetesmortality, not associated; I2 = 78%
1.82(0.73–4.57)
Insulin resistancerecurrent stroke; I2 = 55%
1.56(1.19–2.05)
Insulin resistancemortality, not associated; I2 = 85%
1.31(0.66–2.59)
Original publication
Impaired glucose metabolism and the risk of vascular events and mortality after ischemic stroke: A systematic review and meta-analysis. Cardiovasc Diabetol. Published 31 August 2024. doi:10.
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