Evidence map›Paper›PMID 33854362›Full record

ArticleInternational journal of general medicine2021

Population-based Study Comparing Predictors of Ischemic Stroke Recurrence After Index Ischemic Stroke in Non-elderly Adults with or without Diabetes.

Marwa Elsaeed Elhefnawy, Siti Maisharah Sheikh Ghadzi, Balamurugan Tangiisuran, Hadzliana Zainal, Irene Looi, Khairul Azmi Ibrahim, Norsima Nazifah Sidek, Keat Wei Loo, Keng Yee Lee, Zariah Abdul Aziz and 1 more

Open access · goldAbstract read
In one paragraph

Article in International journal of general medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Marwa Elsaeed ElhefnawySchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.ORCID 0000-0001-8801-8982
Siti Maisharah Sheikh GhadziSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.
Balamurugan TangiisuranSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.
Hadzliana ZainalSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.
Irene LooiClinical Research Centre, Seberang Jaya Hospital, Penang, Malaysia.
Khairul Azmi IbrahimClinical Research Centre, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.ORCID 0000-0002-2109-1138
Norsima Nazifah SidekClinical Research Centre, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.
Keat Wei LooDepartment of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Kampar Campus, Perak, Malaysia.
Keng Yee LeeNational Clinical Research Centre, Kuala Lumpur, Malaysia.ORCID 0000-0002-0022-5539
Zariah Abdul AzizClinical Research Centre, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.
Sabariah Noor HarunSchool of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, 11800, Malaysia.ORCID 0000-0001-8476-7425
Universiti Sains Malaysia · MYHospital Sultanah Nur Zahirah · MYHospital Seberang Jaya · MYUniversiti Tunku Abdul Rahman · MY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeFactors associated with ischemic stroke (IS) recurrence and the contribution of pharmacological treatment as secondary preventions among nondiabetics especially in the non-elderly population are unclear and not widely investigated. This was a population-based study that aimed to identify recurrent IS predictors and to determine the possible impact of secondary preventive medications on the IS recurrence in non-elderly adults with or without diabetes.

methodsData of 3386 patients <60 years old who had a history of index IS were extracted from the Malaysian National Neurology Registry (NNEUR) from 2009 to 2016. Recurrent IS was defined as any IS event recorded after the index IS in the NNEUR database. Multivariate logistic regression analysis was performed by using SPSS version 22.

resultsIschemic heart disease (IHD) was the significant predictor of IS recurrence in non-elderly adults both with or without diabetes (adjusted odds ratio (AOR) of 3.210; 95%CI: 1.909-5.398 and 2.989; 95%CI: 1.515-5.894) respectively). Receiving antiplatelet as secondary stroke prevention (AOR: 0.194; 95%CI: 0.046-0.817) and continuation of antidiabetic medication after the index IS event (AOR: 0.510; 95%CI: 0.298-0.872) reduced the odds of IS recurrence only in non-elderly diabetic adults. Among non-elderly adults without diabetes, hyperlipidemia and every increased in 1 mmHg of systolic blood pressure significantly increased the odds of IS recurrence following the indexing event (AOR: 1.796; 95%CI: 1.058-3.051 and 1.009; 95%CI: 1.002-1.016 respectively).

conclusionIHD was found as the main predictor of IS recurrence regardless of diabetes status in non-elderly adults after the index IS event. Receiving antidiabetic and antiplatelet medications upon discharge after index IS were significant predictors of recurrent IS in non-elderly diabetic adults. A proper randomized clinical trial may be required to determine the impact of secondary preventive medication on IS recurrence, especially in non-elderly adults.

Indexed as

diabeticischemic strokenondiabeticnon-elderlypreventionrecurrence

Identifiers

PMID33854362
PMCPMC8039196
OpenAlexW3150974599

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.