Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.
BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance in the Nateglinide and Valsartan in Impaire...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2013
|
| _version_ | 1826260670755110912 |
|---|---|
| author | Preiss, D Giles, T Thomas, L Sun, J Haffner, S Holman, R Standl, E Mazzone, T Rutten, G Tognoni, G Chiang, F McMurray, J Califf, R |
| author_facet | Preiss, D Giles, T Thomas, L Sun, J Haffner, S Holman, R Standl, E Mazzone, T Rutten, G Tognoni, G Chiang, F McMurray, J Califf, R |
| author_sort | Preiss, D |
| collection | OXFORD |
| description | BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance in the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Cox proportional-hazard regression models were constructed using baseline variables, including the 2 medications studied, valsartan and nateglinide. RESULTS: Among 9306 participants, 237 experienced a stroke over 6.4 years. Predictors of stroke included classical risk factors such as existing cerebrovascular and coronary heart disease, higher pulse pressure, higher low-density lipoprotein cholesterol, older age, and atrial fibrillation. Other factors, including previous venous thromboembolism, higher waist circumference, lower estimated glomerular filtration rate, lower heart rate, and lower body mass index, provided additional important predictive information, yielding a C-index of 0.72. Glycemic measures were not predictive of stroke. Variables associated with stroke were similar in participants with no prior history of cerebrovascular disease at baseline. CONCLUSIONS: The most powerful predictors of stroke in patients with impaired glucose tolerance included a combination of established risk factors and novel variables, such as previous venous thromboembolism and elevated waist circumference, allowing moderately effective identification of high-risk individuals. |
| first_indexed | 2024-03-06T19:09:22Z |
| format | Journal article |
| id | oxford-uuid:163fb1d5-8625-4e14-a638-e8532552025d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:09:22Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:163fb1d5-8625-4e14-a638-e8532552025d2022-03-26T10:30:14ZPredictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:163fb1d5-8625-4e14-a638-e8532552025dEnglishSymplectic Elements at Oxford2013Preiss, DGiles, TThomas, LSun, JHaffner, SHolman, RStandl, EMazzone, TRutten, GTognoni, GChiang, FMcMurray, JCaliff, R BACKGROUND AND PURPOSE: Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance. METHODS: We identified predictors of stroke among participants with impaired glucose tolerance in the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Cox proportional-hazard regression models were constructed using baseline variables, including the 2 medications studied, valsartan and nateglinide. RESULTS: Among 9306 participants, 237 experienced a stroke over 6.4 years. Predictors of stroke included classical risk factors such as existing cerebrovascular and coronary heart disease, higher pulse pressure, higher low-density lipoprotein cholesterol, older age, and atrial fibrillation. Other factors, including previous venous thromboembolism, higher waist circumference, lower estimated glomerular filtration rate, lower heart rate, and lower body mass index, provided additional important predictive information, yielding a C-index of 0.72. Glycemic measures were not predictive of stroke. Variables associated with stroke were similar in participants with no prior history of cerebrovascular disease at baseline. CONCLUSIONS: The most powerful predictors of stroke in patients with impaired glucose tolerance included a combination of established risk factors and novel variables, such as previous venous thromboembolism and elevated waist circumference, allowing moderately effective identification of high-risk individuals. |
| spellingShingle | Preiss, D Giles, T Thomas, L Sun, J Haffner, S Holman, R Standl, E Mazzone, T Rutten, G Tognoni, G Chiang, F McMurray, J Califf, R Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title | Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title_full | Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title_fullStr | Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title_full_unstemmed | Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title_short | Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial. |
| title_sort | predictors of stroke in patients with impaired glucose tolerance results from the nateglinide and valsartan in impaired glucose tolerance outcomes research trial |
| work_keys_str_mv | AT preissd predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT gilest predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT thomasl predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT sunj predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT haffners predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT holmanr predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT standle predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT mazzonet predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT rutteng predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT tognonig predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT chiangf predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT mcmurrayj predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial AT califfr predictorsofstrokeinpatientswithimpairedglucosetoleranceresultsfromthenateglinideandvalsartaninimpairedglucosetoleranceoutcomesresearchtrial |