Abstract 13621: Stroke in People with Impaired Glucose Tolerance
Background: People with impaired glucose tolerance (IGT) are known to be at high risk of vascular events, but little is known about their risk of stroke.
Methods: In NAVIGATOR, all 9306 participants had IGT as documented by screening glucose-tolerance testing, a fasting glucose≥95mg/dL, <126 mg/dL, and ≥1 cardiovascular (CV) risk factors or known CV disease. Participants were randomly allocated in a 2 by 2 factorial design to nateglinide, valsartan, both, or neither. Risk factors for stroke were determined via forward selection in a Cox proportional hazard model.
Results: While neither treatment significantly reduced CV events, 237 participants experienced a documented stroke during a median follow-up of 6.4 years, yielding a rate of 0.42 per 100 patient years. 27 strokes were fatal, and 210 were nonfatal. Risk factors were determined in the entire cohort and in those without a history of cerebrovascular disease prior to enrollment. The table shows the significant risk factors (model C index=0.721 in entire cohort and 0.723 in those without a history of cerebrovascular disease).
Conclusion: Stroke is a significant problem for people with IGT without a diagnosis of diabetes, and is predicted by the usual risk factors. However, atrial fibrillation and blood pressure were not significant determinants. In this population with IGT, a history of venous thromboembolic disease and black race were additional major risk factors.
- © 2011 by American Heart Association, Inc.