Open AccessDiabetes As an Independent Risk Factor for Stroke Recurrence in Ischemic Stroke Patients: An Updated Meta-Analysis
Author(s) -
Li Zhang,
Xianqi Li,
Charles D A Wolfe,
Matthew D L O’Connell,
Yanzhong Wang
Publication year - 2021
Publication title -
neuroepidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.217
H-Index - 87
eISSN - 1423-0208
pISSN - 0251-5350
DOI - 10.1159/000519327
Subject(s) - medicine , diabetes mellitus , stroke (engine) , funnel plot , publication bias , hazard ratio , meta analysis , confidence interval , risk factor , population , incidence (geometry) , endocrinology , mechanical engineering , physics , environmental health , optics , engineering
Stroke and its recurrence and diabetes will increase in incidence as the population ages globally. This study explores the relationship between diabetes and stroke recurrence to understand if diabetes is an independent predictor for stroke recurrence in ischemic stroke (IS) patients. Methods: We conducted a systematic review and meta-analysis of studies on the effect of diabetes on stroke recurrence among patients with IS. We searched population-based studies published before 15th February 2021 in PubMed and EMBASE following PRISMA guidelines. Random-effects estimates of the pooled hazard ratio (HR) and 95% confidence intervals (CIs) of each study were generated. A funnel plot and an Egger test were performed to evaluate publication bias. All statistical analyses were conducted in the R software 4.0.1 and Stata 16.0. Results: The search identified 3,121 citations, of which 27 studies met inclusion criteria. Diabetes was associated with a significant risk of stroke recurrence in all IS patients (pooled HR, 1.50; 95% CI: 1.36–1.65; I 2 = 61.0%). Similar results were found in lacunar stroke patients with diabetes (pooled HR, 1.65; 95% CI: 1.41–1.92; I 2 = 22.0%). Moreover, we found that the risk of recurrent IS among patients of IS with diabetes was higher than that in those without diabetes (pooled HR, 1.53; 95% CI: 1.30–1.81; I 2 = 74.0%). Conclusion: Diabetes is an independent risk factor for stroke recurrence among patients with IS.