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- Title
Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study.
- Authors
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.
- 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.
- Subjects
DIABETES complications; DIABETIC retinopathy; CREATININE; AMERICAN Diabetes Association; MEDICAL research
- Publication
Diabetic Medicine, 2008, Vol 25, Issue 10, p1171
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/j.1464-5491.2008.02567.x