Interaction of sex and diabetes on outcome after ischemic stroke

BACKGROUND: The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. METHODS: In a retros...

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Autores: Soriano Reixach, Maria Montserrat, Vivanco Hidalgo, Rosa María, Ois Santiago, Angel Javier, Rodríguez-Campello, Ana, Roquer, Jaume
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/37143
Acesso em linha:http://hdl.handle.net/10230/37143
http://dx.doi.org/10.3389/fneur.2018.00250
Access Level:acceso abierto
Palavra-chave:Diabetis
Isquèmia
Diabetes
Ischemic stroke
Mortality
Outcome
Sex differences
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spelling Interaction of sex and diabetes on outcome after ischemic strokeSoriano Reixach, Maria MontserratVivanco Hidalgo, Rosa MaríaOis Santiago, Angel JavierRodríguez-Campello, AnaRoquer, JaumeDiabetisIsquèmiaDiabetesIschemic strokeMortalityOutcomeSex differencesBACKGROUND: The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. METHODS: In a retrospective, observational, hospital-based study of a prospective series including first-ever IS patients from January 2006 until July 2011, differences in 3-month and 5-year mortality, and disability between diabetic and non-diabetic patients [modified Rankin Scale (mRS) from 3 to 5] were analyzed by sex. RESULTS: In total, 933 patients (36.3% with DM, 50.5% women) were included. Overall 3-month and 5-year mortality were 150 (16.1%) and 407 (44.1%), respectively. Adjusted for age, previous mRS, and stroke severity, patients with DM had significantly higher 3-month disability [hazard ratio (HR): 1.49 (95% confidence interval (CI): 1.39-1.70), p < 0.0001], 5-year disability [HR: 1.41 (95% CI: 1.07-1.86), p = 0.015], and 5-year mortality [HR: 1.48 (95% CI: 1.20-1.81), p < 0.0001], compared with the non-DM group. Compared with non-DM women, women with diabetes had worse 3-month disability [HR: 1.81 (95% CI: 1.33-2.46), p < 0.0001] and 5-year mortality [HR: 1.72 (95% CI: 1.30-2.20), p < 0.0001], and a trend for 5-year disability [HR: 1.40 (95% CI: 0.99-2.09), p = 0.057]. In men, DM had an effect on 3-month disability [HR: 1.45 (95% CI: 1.07-1.96), p = 0.018], a trend for 5-year disability [HR: 1.43 (95% CI: 0.94-2.19), p = 0.096], but no clear effect on 5-year mortality [HR: 1.22 (95% CI: 0.91-1.65), p = 0.186]. CONCLUSION: Sex has a modifier effect on mortality in first-ever IS diabetic patients. Long-term mortality is increased in diabetic women compared with non-diabetic women, a difference not observed in men.Frontiers201920192018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/37143http://dx.doi.org/10.3389/fneur.2018.00250reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésFrontiers in Neurology. 2018 Apr 13;9:250© 2018 Soriano-Reixach, Vivanco-Hidalgo, Ois, Rodríguez-Campello and Roquer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/371432026-06-12T07:21:37Z
dc.title.none.fl_str_mv Interaction of sex and diabetes on outcome after ischemic stroke
title Interaction of sex and diabetes on outcome after ischemic stroke
spellingShingle Interaction of sex and diabetes on outcome after ischemic stroke
Soriano Reixach, Maria Montserrat
Diabetis
Isquèmia
Diabetes
Ischemic stroke
Mortality
Outcome
Sex differences
title_short Interaction of sex and diabetes on outcome after ischemic stroke
title_full Interaction of sex and diabetes on outcome after ischemic stroke
title_fullStr Interaction of sex and diabetes on outcome after ischemic stroke
title_full_unstemmed Interaction of sex and diabetes on outcome after ischemic stroke
title_sort Interaction of sex and diabetes on outcome after ischemic stroke
dc.creator.none.fl_str_mv Soriano Reixach, Maria Montserrat
Vivanco Hidalgo, Rosa María
Ois Santiago, Angel Javier
Rodríguez-Campello, Ana
Roquer, Jaume
author Soriano Reixach, Maria Montserrat
author_facet Soriano Reixach, Maria Montserrat
Vivanco Hidalgo, Rosa María
Ois Santiago, Angel Javier
Rodríguez-Campello, Ana
Roquer, Jaume
author_role author
author2 Vivanco Hidalgo, Rosa María
Ois Santiago, Angel Javier
Rodríguez-Campello, Ana
Roquer, Jaume
author2_role author
author
author
author
dc.subject.none.fl_str_mv Diabetis
Isquèmia
Diabetes
Ischemic stroke
Mortality
Outcome
Sex differences
topic Diabetis
Isquèmia
Diabetes
Ischemic stroke
Mortality
Outcome
Sex differences
description BACKGROUND: The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. METHODS: In a retrospective, observational, hospital-based study of a prospective series including first-ever IS patients from January 2006 until July 2011, differences in 3-month and 5-year mortality, and disability between diabetic and non-diabetic patients [modified Rankin Scale (mRS) from 3 to 5] were analyzed by sex. RESULTS: In total, 933 patients (36.3% with DM, 50.5% women) were included. Overall 3-month and 5-year mortality were 150 (16.1%) and 407 (44.1%), respectively. Adjusted for age, previous mRS, and stroke severity, patients with DM had significantly higher 3-month disability [hazard ratio (HR): 1.49 (95% confidence interval (CI): 1.39-1.70), p < 0.0001], 5-year disability [HR: 1.41 (95% CI: 1.07-1.86), p = 0.015], and 5-year mortality [HR: 1.48 (95% CI: 1.20-1.81), p < 0.0001], compared with the non-DM group. Compared with non-DM women, women with diabetes had worse 3-month disability [HR: 1.81 (95% CI: 1.33-2.46), p < 0.0001] and 5-year mortality [HR: 1.72 (95% CI: 1.30-2.20), p < 0.0001], and a trend for 5-year disability [HR: 1.40 (95% CI: 0.99-2.09), p = 0.057]. In men, DM had an effect on 3-month disability [HR: 1.45 (95% CI: 1.07-1.96), p = 0.018], a trend for 5-year disability [HR: 1.43 (95% CI: 0.94-2.19), p = 0.096], but no clear effect on 5-year mortality [HR: 1.22 (95% CI: 0.91-1.65), p = 0.186]. CONCLUSION: Sex has a modifier effect on mortality in first-ever IS diabetic patients. Long-term mortality is increased in diabetic women compared with non-diabetic women, a difference not observed in men.
publishDate 2018
dc.date.none.fl_str_mv 2018
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/37143
http://dx.doi.org/10.3389/fneur.2018.00250
url http://hdl.handle.net/10230/37143
http://dx.doi.org/10.3389/fneur.2018.00250
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Frontiers in Neurology. 2018 Apr 13;9:250
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Frontiers
publisher.none.fl_str_mv Frontiers
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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