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Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study.
Diabet Med. 2008 Oct; 25(10):1171-7.DM

Abstract

AIMS

We investigated whether cardiovascular autonomic neuropathy (CAN) is associated with acute ischaemic stroke in patients with Type 2 diabetes.

METHODS

From 1999 to 2000, cardiovascular autonomic function tests were conducted in patients with Type 2 diabetes (n = 1458). Patients were followed up between 2006 and 2007. Standard tests for CAN measured heart rate variability parameters [expiration-to-inspiration (E/I) ratio, responses to the Valsalva manoeuvre and standing]. Using the American Diabetes Association criteria, the CAN scores were determined from the results of each test as follows: 0 = normal, 1 = abnormal (total maximum score 3). We assessed the development of acute ischaemic stroke events.

RESULTS

The prevalence of CAN at baseline was 55.7% (E/I 17.1%, Valsalva 39.4%, posture 27.3%) (n = 1126). During follow-up, 131 patients (11.6%) developed acute ischaemic stroke. The vascular events were more frequent in older patients (P < 0.001) and in those with diabetes of longer duration (P = 0.022), hypertension (P < 0.001) or diabetic retinopathy (P = 0.03) than in patients without vascular events. Patients with ischaemic stroke had higher creatinine levels (P = 0.045) and higher urine albumin excretion (P = 0.025) than those of patients without stroke. Cox proportional hazard regression analysis revealed that the CAN score was associated with the development of acute ischaemic stroke (total score 0 vs. 3, adjusted hazard ratio 2.7, 95% CI 1.3-5.5, P = 0.006).

CONCLUSION

Cardiovascular autonomic dysfunction was significantly associated with the development of ischaemic stroke in patients with Type 2 diabetes.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19046195

Citation

Ko, S H., et al. "Cardiovascular Autonomic Dysfunction Predicts Acute Ischaemic Stroke in Patients With Type 2 Diabetes Mellitus: a 7-year Follow-up Study." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 25, no. 10, 2008, pp. 1171-7.
Ko SH, Song KH, Park SA, et al. Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study. Diabet Med. 2008;25(10):1171-7.
Ko, S. H., Song, K. H., Park, S. A., Kim, S. R., Cha, B. Y., Son, H. Y., Moon, K. W., Yoo, K. D., Park, Y. M., Cho, J. H., Yoon, K. H., & Ahn, Y. B. (2008). Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study. Diabetic Medicine : a Journal of the British Diabetic Association, 25(10), 1171-7. https://doi.org/10.1111/j.1464-5491.2008.02567.x
Ko SH, et al. Cardiovascular Autonomic Dysfunction Predicts Acute Ischaemic Stroke in Patients With Type 2 Diabetes Mellitus: a 7-year Follow-up Study. Diabet Med. 2008;25(10):1171-7. PubMed PMID: 19046195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study. AU - Ko,S H, AU - Song,K H, AU - Park,S A, AU - Kim,S R, AU - Cha,B Y, AU - Son,H Y, AU - Moon,K W, AU - Yoo,K D, AU - Park,Y M, AU - Cho,J H, AU - Yoon,K H, AU - Ahn,Y B, PY - 2008/12/3/pubmed PY - 2009/10/10/medline PY - 2008/12/3/entrez SP - 1171 EP - 7 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 25 IS - 10 N2 - AIMS: We investigated whether cardiovascular autonomic neuropathy (CAN) is associated with acute ischaemic stroke in patients with Type 2 diabetes. METHODS: From 1999 to 2000, cardiovascular autonomic function tests were conducted in patients with Type 2 diabetes (n = 1458). Patients were followed up between 2006 and 2007. Standard tests for CAN measured heart rate variability parameters [expiration-to-inspiration (E/I) ratio, responses to the Valsalva manoeuvre and standing]. Using the American Diabetes Association criteria, the CAN scores were determined from the results of each test as follows: 0 = normal, 1 = abnormal (total maximum score 3). We assessed the development of acute ischaemic stroke events. RESULTS: The prevalence of CAN at baseline was 55.7% (E/I 17.1%, Valsalva 39.4%, posture 27.3%) (n = 1126). During follow-up, 131 patients (11.6%) developed acute ischaemic stroke. The vascular events were more frequent in older patients (P < 0.001) and in those with diabetes of longer duration (P = 0.022), hypertension (P < 0.001) or diabetic retinopathy (P = 0.03) than in patients without vascular events. Patients with ischaemic stroke had higher creatinine levels (P = 0.045) and higher urine albumin excretion (P = 0.025) than those of patients without stroke. Cox proportional hazard regression analysis revealed that the CAN score was associated with the development of acute ischaemic stroke (total score 0 vs. 3, adjusted hazard ratio 2.7, 95% CI 1.3-5.5, P = 0.006). CONCLUSION: Cardiovascular autonomic dysfunction was significantly associated with the development of ischaemic stroke in patients with Type 2 diabetes. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/19046195/Cardiovascular_autonomic_dysfunction_predicts_acute_ischaemic_stroke_in_patients_with_Type_2_diabetes_mellitus:_a_7_year_follow_up_study_ DB - PRIME DP - Unbound Medicine ER -