Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.

<h4>Objective</h4>To investigate whether asymptomatic middle cerebral artery (MCA) stenosis is associated with risk of cardiovascular disease (CVD) in Chinese with type 2 diabetes.<h4>Methods</h4>In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes a...

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Autores principales:	Jian Gang Duan, Xiang Yan Chen, Alex Lau, Adrian Wong, G Neil Thomas, Brian Tomlinson, Roxanna Liu, Juliana C N Chan, Thomas W Leung, Vincent Mok, Ka Sing Wong
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4e669e391fd54218ab77645dd044e4f6
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spelling	oai:doaj.org-article:4e669e391fd54218ab77645dd044e4f62021-11-25T06:01:42ZLong-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.1932-620310.1371/journal.pone.0106623https://doaj.org/article/4e669e391fd54218ab77645dd044e4f62014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25192283/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To investigate whether asymptomatic middle cerebral artery (MCA) stenosis is associated with risk of cardiovascular disease (CVD) in Chinese with type 2 diabetes.<h4>Methods</h4>In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994-1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS) or cardiovascular death.<h4>Results</h4>Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%). Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001). After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR) 1.40, 95%CI 1.05-1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04-1.75; P = 0.02) and cardiovascular death(HR 1.56, 95%CI 1.04-2.33; P = 0.03).<h4>Conclusions</h4>Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common.Jian Gang DuanXiang Yan ChenAlex LauAdrian WongG Neil ThomasBrian TomlinsonRoxanna LiuJuliana C N ChanThomas W LeungVincent MokKa Sing WongPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e106623 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jian Gang Duan Xiang Yan Chen Alex Lau Adrian Wong G Neil Thomas Brian Tomlinson Roxanna Liu Juliana C N Chan Thomas W Leung Vincent Mok Ka Sing Wong Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
description	<h4>Objective</h4>To investigate whether asymptomatic middle cerebral artery (MCA) stenosis is associated with risk of cardiovascular disease (CVD) in Chinese with type 2 diabetes.<h4>Methods</h4>In this prospective cohort study, 2,144 Hong Kong Chinese with type 2 diabetes and without history of stroke or atrial fibrillation were recruited in 1994-1996 and followed up for a median of 14.51 years. Participants were assessed at baseline for MCA stenosis using transcranial Doppler. We performed survival analysis to assess the association between asymptomatic MCA stenosis and first CVD event, defined as ischemic stroke, acute coronary syndrome (ACS) or cardiovascular death.<h4>Results</h4>Of the 2,144 subjects, MCA stenosis at baseline was detected in 264 (12.3%). Rates of stroke, ACS and cardiovascular death per 100 were, respectively, 2.24, 2.92 and 1.11 among participants with stenosis, higher than among those without stenosis. Ten-year cumulative occurrence of stroke, ACS and cardiovascular death in subjects with MCA stenosis was 20%, 24% and 10%, respectively, higher than the corresponding values for subjects without stenosis(all P<0.001). After adjusting for covariates, MCA stenosis was found to be an independent predictor of stroke [hazard ratio (HR) 1.40, 95%CI 1.05-1.86; P = 0.02], ACS (HR 1.35, 95%CI 1.04-1.75; P = 0.02) and cardiovascular death(HR 1.56, 95%CI 1.04-2.33; P = 0.03).<h4>Conclusions</h4>Asymptomatic MCA stenosis is a risk factor for CVD in Chinese with type 2 diabetes, and detection of asymptomatic MCA stenosis by transcranial Doppler can identify diabetic individuals at high risk of future CVD. This finding is particularly important for diabetic individuals in Asia, where intracranial atherosclerosis is common.
format	article
author	Jian Gang Duan Xiang Yan Chen Alex Lau Adrian Wong G Neil Thomas Brian Tomlinson Roxanna Liu Juliana C N Chan Thomas W Leung Vincent Mok Ka Sing Wong
author_facet	Jian Gang Duan Xiang Yan Chen Alex Lau Adrian Wong G Neil Thomas Brian Tomlinson Roxanna Liu Juliana C N Chan Thomas W Leung Vincent Mok Ka Sing Wong
author_sort	Jian Gang Duan
title	Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
title_short	Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
title_full	Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
title_fullStr	Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
title_full_unstemmed	Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
title_sort	long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/4e669e391fd54218ab77645dd044e4f6
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Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study.

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