Population-based Study Comparing Predictors of Ischemic Stroke Recurrence After Index Ischemic Stroke in Non-elderly Adults with or without Diabetes

Figures & data

Table 1 Characteristics of Diabetics and Nondiabetics Non-elderly Adults (Aged <60 Years) with History of Index Ischemic Stroke Attack that were Included in the Study (N=3386)

Variable	Diabetic Patients N=1576		Nondiabetic Patients N=1810
	N	%	N	%
Age subgroups
<49 years	367	23.3	655	36.2
≥49 to <60 years	1208	76.7	1155	63.8
Female	831	52.72	1164	64.30
Recurrent stroke	96	6.1	69	3.8
Obesity	651	41.3	902	53.0
BMI, mean (±SD)	28.49 (±5.97)		29.69 (±6.044)
Ethnicity
Malay	385	24.4	331	18.3
Chinese	27	1.7	34	1.9
Indian	29	1.8	20	1.1
Others	1135	72	1425	78.7
Education
Informal	382	24.2	484	26.7
Formal	1194	75.8	1326	73.3
Smoker	844	53.6	891	49.2
Duration of diabetes (years)
<1	138	8.8	–	–
1–5	645	40.9	–	–
6–10	222	14.1	–	–
>10	213	13.5	–	–
Unknown	358	22.7	–	–
Family history of stroke	98	6.2	162	9.0
HTN	1299	82.4	959	53.0
SBP, mean (±SD)	165.28 (±32.43)		164.12 (±34.74)
DBP, mean (±SD)	92.17 (±17.51)		94.51 (±19.60)
HTN duration (years)
<1–5	618	39.2	531	29.3
6–10	196	12.4	134	7.4
>10	197	12.5	87	4.8
Unknown	288	18.3	207	11.4
IHD	186	11.8	133	7.3
Hyperlipidemia	528	33.5	374	20.7
Total cholesterol (mmol/L), mean (±SD)	6.18 (±1.86)		5.86 (±1.64)
Atrial fibrillation	21	1.3	51	2.8
Death	114	7.2%	95	5.2%

Abbreviations: BMI, body mass index; IHD, ischemic heart disease; HTN, hypertension.

Table 2 Univariate and Multivariable Logistic Regression Analysis of Variables Associated with Recurrent Ischemic Stroke in Diabetic and Nondiabetic Non-elderly Adults (Aged <60 Years) After Index Ischemic Stroke Attack (N=3386)

Variables^a	Diabetics with IS Recurrence N=96 (%)	Diabetics without IS Recurrence N=1480 (%)	P-value	Adjusted Odds Ratio, AOR (95%CI)	P-value
SBP, mean (±SD)	172.74 (±34.60)	164.80 (±32.24)	0.021	1.007 (1.001–1.014)	0.051
Duration of HTN (years)			0.001
<1–5	48 (50.0)	570 (38.5)		1.138 (0.606–2.135)	0.688
6–10	8 (8.3)	188 (12.7)		0.490 (0.189–1.268)	0.141
>10	20 (20.8)	177 (12.0)		1.347 (0.637–2.845)	0.435
IHD	26 (27.1)	160 (10.8)	0.000	3.210 (1.909–5.398)	0.00
Received diuretics at baseline^b	22 (22.9)	179 (12.1)	0.002	0.659 (0.368–1.180)	0.160
Received diuretic upon discharge^c	17 (17.7)	104 (7.0)	0.000	0.563 (0.295–1.074)	0.081
Received antiplatelet upon discharge^c	94 (97.9)	1250 (84.5)	0.000	0.194 (0.046–0.817)	0.025
Received ADM upon discharge^c	77 (80.2)	896 (60.5)	0.000	0.510 (0.298–0.872)	0.014
Clinical manifestation apparent at start of index IS attack: Speech disturbance	44 (45.8)	834 (57.7)	0.023	1.539 (0.996–2.378)	0.052
Total score of NIHSS upon acute index IS event
No and minor symptoms	52 (54.2)	612 (42.3)	0.023
Moderate and severe symptoms	44 (45.8)	834 (57.7)		1.358 (0.871–2.117)	0.177
Variables^a	Non-Diabetics with IS Recurrence N=69 (%)	Non-Diabetics without IS Recurrence N=1741 (%)	P-value	Adjusted Odds Ratio AOR (95%CI)	P-value
SBP, mean (±SD)	172.59 (±38.64)	163.78 (±34.54)	0.039	1.009 (1.002–1.016)	0.012
Smoker	42 (60.9)	849 (48.8)	0.049	1.663 (0.995–2.779)	0.052
Hyperlipidemia	24 (34.8)	350 (20.1)	0.003	1.796 (1.058–3.051)	0.030
IHD	12 (17.4)	121 (7.0)	0.001	2.989 (1.515–5.894)	0.002
Clinical manifestation apparent at start of index IS attack: hemiparesis	59 (88.1)	1330 (77.1)	0.036	2.064 (0.974–4.376)	0.059

Notes: ^aVariables that were significant in univariate analysis and included into the multivariate logistic regression analysis. ^bBaseline is defined as prior to index ischemic stroke attack. ^cDischarge from hospital admission after index ischemic stroke. Significance P<0.05; highlighted in grey indicates statistically significant in the final multivariate logistic regression model.

Abbreviations: ADM, antidiabetic medications; HTN, hypertension; IS, ischemic stroke; NIHSS, National Institutes of Health Stroke Scale; AOR, adjusted odds ratio; IHD, ischemic heart disease; IS, ischemic stroke.