論文

国際誌
2021年9月3日

Impact of prior cerebrovascular disease and glucose status on incident cerebrovascular disease in Japanese.

Cardiovascular diabetology
  • Momoko Oe
  • ,
  • Kazuya Fujihara
  • ,
  • Mayuko Harada-Yamada
  • ,
  • Taeko Osawa
  • ,
  • Masaru Kitazawa
  • ,
  • Yasuhiro Matsubayashi
  • ,
  • Takaaki Sato
  • ,
  • Yuta Yaguchi
  • ,
  • Midori Iwanaga
  • ,
  • Hiroyasu Seida
  • ,
  • Takaho Yamada
  • ,
  • Hirohito Sone

20
1
開始ページ
174
終了ページ
174
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12933-021-01367-7

BACKGROUND: Although both a history of cerebrovascular disease (CVD) and glucose abnormality are risk factors for CVD, few large studies have examined their association with subsequent CVD in the same cohort. Thus, we compared the impact of prior CVD, glucose status, and their combinations on subsequent CVD using real-world data. METHODS: This is a retrospective cohort study including 363,627 men aged 18-72 years followed for ≥ 3 years between 2008 and 2016. Participants were classified as normoglycemia, borderline glycemia, or diabetes defined by fasting plasma glucose, HbA1c, and antidiabetic drug prescription. Prior and subsequent CVD (i.e. ischemic stroke, transient ischemic attack, and non-traumatic intracerebral hemorrhage) were identified according to claims using ICD-10 codes, medical procedures, and questionnaires. RESULTS: Participants' mean age was 46.1 ± 9.3, and median follow up was 5.2 (4.2, 6.7) years. Cox regression analysis showed that prior CVD + conferred excess risk for CVD regardless of glucose status (normoglycemia: hazard ratio (HR), 8.77; 95% CI 6.96-11.05; borderline glycemia: HR, 7.40, 95% CI 5.97-9.17; diabetes: HR, 5.73, 95% CI 4.52-7.25). Compared with normoglycemia, borderline glycemia did not influence risk of CVD, whereas diabetes affected subsequent CVD in those with CVD- (HR, 1.50, 95% CI 1.34-1.68). In CVD-/diabetes, age, current smoking, systolic blood pressure, high-density lipoprotein cholesterol, and HbA1c were associated with risk of CVD, but only systolic blood pressure was related to CVD risk in CVD + /diabetes. CONCLUSIONS: Prior CVD had a greater impact on the risk of CVD than glucose tolerance and glycemic control. In participants with diabetes and prior CVD, systolic blood pressure was a stronger risk factor than HbA1c. Individualized treatment strategies should consider glucose tolerance status and prior CVD.

リンク情報
DOI
https://doi.org/10.1186/s12933-021-01367-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34479567
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417951
ID情報
  • DOI : 10.1186/s12933-021-01367-7
  • PubMed ID : 34479567
  • PubMed Central 記事ID : PMC8417951

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