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Association between prediabetes and higher risk of mortality following acute ischemic stroke: A meta-analysis

Year: 2026
Type: review
Abstract: BACKGROUND Prediabetes increases the risk of cardiovascular and cerebrovascular mortality. This study examines the relationship between prediabetes and mortality in post-stroke patients. AIM To determine whether prediabetes is associated with increased post-stroke mortality in adults with acute ischemic stroke (IS). METHODS A systematic search was conducted in PubMed/MEDLINE, Scopus, and Google Scholar databases until May 2023 to identify relevant articles reporting on the association of prediabetes with IS mortality. A random-effects model was used to calculate odds ratio (OR), heterogeneity was assessed using I 2 statistics, and sensitivity analysis was performed using the leave-one-out method. RESULTS Our analysis of 11 studies included 84833 prediabetic patients with a mean follow-up time of 20.9 months. The prediabetes cohort comprised patients of an average age of 67 years from various countries, including Korea, Italy, Japan, China, Spain, and the Netherlands. Although, the unadjusted analysis showed no significant association between prediabetes and post-stroke mortality (OR = 1.06, 95%CI: 0.51-2.19) with high heterogeneity (I 2 = 94.7%, P < 0.01). Post-adjustment for baseline characteristics and comorbidities, the prediabetes cohort exhibited a significantly higher risk of post-stroke mortality (adjusted OR = 1.68, 95%CI: 1.29-2.19) with moderate heterogeneity (I 2 = 49.45%, P = 0.03). Subgroup analysis by country revealed non-significant higher odds of mortality in Korea, Italy, Spain, Japan, and the Netherlands, indicating the need for more extensive studies. CONCLUSION Our findings suggest that prediabetes is associated with a nearly 68% higher mortality risk following a stroke. Thereby warranting more prospective studies with prediabetes to validate these findings.
DOI: 10.4239/wjd.v17.i1.110528
Authors: Bhavin Patel, Kshitij Mahajan, Arankesh Mahadevan, Rishika Trivedi, Avleen Dhingra, Samrath Singh Brar, Sakshi Dixit, Rupak Desai
Institutions: Trinity Health Oakland Hospital, Wayne State University, University of Utah, University of Utah Health Care, Doctors Hospital at Renaissance, Dayanand Medical College & Hospital, Trinity Health, Cleveland Clinic Akron General
Language: English
Subfield: Epidemiology
Field: Medicine
Open Access status: diamond
Funders: Chungnam National University, Dong-A University, Eulji University, Konyang University, Seoul National University, Soonchunhyang University, Yonsei University, Ajou University, Sungkyunkwan University, Seoul National University Hospital, CHA University, College of Medicine, Seoul National University, Yonsei University College of Medicine
OpenAlex ID: W7123729128
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Cites: 23
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