医学
危险系数
四分位数
内科学
冲程(发动机)
置信区间
比例危险模型
糖尿病
心脏病学
内分泌学
机械工程
工程类
作者
Yuesong Pan,Xueli Cai,Jing Jing,Xia Meng,Hao Li,Yongjun Wang,Xingquan Zhao,Liping Liu,David Wang,S. Claiborne Johnston,Tiemin Wei,Yilong Wang
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2017-10-20
卷期号:48 (11): 3006-3011
被引量:47
标识
DOI:10.1161/strokeaha.117.019081
摘要
Background and Purpose— We aimed to determine the association between stress hyperglycemia and risk of new stroke in patients with a minor ischemic stroke or transient ischemic attack. Methods— A subgroup of 3026 consecutive patients from 73 prespecified sites of the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) were analyzed. Stress hyperglycemia was measured by glucose/glycated albumin (GA) ratio. Glucose/GA ratio was calculated by fasting plasma glucose divided by GA and categorized into 4 even groups according to the quartiles. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose/GA ratio and risk of stroke by multivariable Cox regression models adjusted for potential covariates. Results— Among 3026 patients included, a total of 299 (9.9%) new stroke occurred at 3 months. Compared with patients with the lowest quartile, patients with the highest quartile of glucose/GA ratio was associated with an increased risk of stroke at 3 months after adjusted for potential covariates (12.0% versus 9.2%; adjusted hazard ratio, 1.46; 95% confidence interval, 1.06–2.01). Similar results were observed after further adjusted for fasting plasma glucose. We also observed that higher level of glucose/GA ratio was associated with an increased risk of stroke with a threshold of 0.29 using a Cox regression model with restricted cubic spline. Conclusions— Stress hyperglycemia, measured by glucose/GA ratio, was associated with an increased risk of stroke in patients with a minor ischemic stroke or transient ischemic attack. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00979589.
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