Abnormal glucose regulation increases stroke risk in minor ischemic stroke or TIA

Neurology. 2016 Oct 11;87(15):1551-1556. doi: 10.1212/WNL.0000000000003200. Epub 2016 Sep 9.


Objective: To investigate whether abnormal glucose regulation contributes to a new stroke in patients with a minor ischemic stroke or TIA.

Methods: We derived data from the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 3 groups: patients with diabetes mellitus (DM), impaired fasting glucose (IFG), and normal fasting plasma glucose. The primary outcome was a new stroke (ischemic or hemorrhagic) at 90 days. We assessed the association between glucose regulation status and risk of stroke by multivariable Cox regression models adjusted for potential covariates.

Results: Among 5,135 included patients, 1,587 (30.9%), 409 (8.0%), and 3,139 (61.1%) patients were identified as DM, IFG, and normal glucose, respectively. Compared with normal glucose, IFG (11.0% vs 6.9%; adjusted hazard ratio [adj HR] 1.57, 95% confidence interval [CI] 1.13-2.19) and DM (15.8% vs 6.9%; adj HR 2.38, 95% CI 1.97-2.88) were associated with increased risk of stroke at 3 months after a minor stroke or TIA after adjusted for potential covariates. We found a weak J-shaped association between fasting plasma glucose and risk of stroke with a nadir of 4.9 mmol/L.

Conclusions: Both IFG and DM were associated with an increased risk of stroke in patients with a minor stroke or TIA.

Clinicaltrialsgov identifier: NCT00979589.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aspirin / therapeutic use
  • Blood Glucose / metabolism*
  • Brain Ischemia / blood*
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy
  • Clopidogrel
  • Diabetes Complications / blood
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recurrence
  • Risk
  • Stroke / blood*
  • Stroke / complications
  • Stroke / drug therapy
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Treatment Outcome


  • Blood Glucose
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin

Associated data

  • ClinicalTrials.gov/NCT00979589