Prognosis and Its Predictors After Incident Stroke in Patients With Type 1 Diabetes
| العنوان: | Prognosis and Its Predictors After Incident Stroke in Patients With Type 1 Diabetes |
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| المؤلفون: | Daniel Gordin, Jukka Putaala, Valma Harjutsalo, Lena M. Thorn, Nina Elonen, Stefanie Hägg-Holmberg, Turgut Tatlisumak, Carol Forsblom, Per-Henrik Groop, Ron Liebkind |
| المصدر: | Diabetes Care. 40:1394-1400 |
| بيانات النشر: | American Diabetes Association, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Diabetic nephropathy, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Diabetic Nephropathies, Renal Insufficiency, Chronic, Young adult, Intensive care medicine, Stroke, Finland, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Incidence, Incidence (epidemiology), Hazard ratio, Middle Aged, Prognosis, medicine.disease, 3. Good health, Diabetes Mellitus, Type 1, Disease Progression, Female, business, 030217 neurology & neurosurgery, Follow-Up Studies, Kidney disease |
| الوصف: | OBJECTIVE Although patients with type 1 diabetes have a poor prognosis after a stroke, predictors of survival after an incident stroke in these patients are poorly studied. RESEARCH DESIGN AND METHODS In this observational study, a total of 144 patients of 4,083 with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study suffered an incident stroke in 1997–2010, and were followed for a mean 3.4 ± 3.1 years after the stroke. Information was recorded on hard cardiovascular events and death as a result of cardiovascular or diabetes-related cause, collectively referred to as vascular composite end point. Information was collected from medical records, death certificates, and the National Care Register of Health Care. Predictors at the time of the incident stroke were studied for the end points. RESULTS During follow-up, 104 (72%) patients suffered a vascular composite end point. Of these, 33 (32%) had a recurrent stroke, 33 (32%) a hard cardiovascular event, and 76 (53%) died of cardiovascular or diabetes-related causes, with an overall 1-year survival of 76% and 5-year survival of 58%. The predictors of a vascular composite end point were hemorrhagic stroke subtype (hazard ratio 2.03 [95% CI 1.29–3.19]), as well as chronic kidney disease stage 2 (2.48 [1.17–5.24]), stage 3 (3.04 [1.54–6.04]), stage 4 (3.95 [1.72–9.04]), and stage 5 (6.71 [3.14–14.34]). All-cause mortality increased with deteriorating kidney function. CONCLUSIONS Patients with type 1 diabetes with an incident stroke have a poor cardiovascular prognosis and a high risk of all-cause mortality. In particular, hemorrhagic stroke subtype and progression of diabetic kidney disease conveys worse outcome. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::95da155b58a3991ca050139b87b72dc3Test https://doi.org/10.2337/dc17-0681Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....95da155b58a3991ca050139b87b72dc3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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