Secondary prevention of stroke with antiplatelet agents in patients with diabetes mellitus.

Détails

ID Serval
serval:BIB_35342
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Secondary prevention of stroke with antiplatelet agents in patients with diabetes mellitus.
Périodique
Cerebrovascular diseases
Auteur(s)
Piechowski-Jozwiak B., Maulaz A., Bogousslavsky J.
ISSN
1015-9770
Statut éditorial
Publié
Date de publication
2005
Volume
20
Numéro
Suppl. 1
Pages
15-23
Langue
anglais
Notes
Publication types: Journal Article ; Review
Résumé
The prevalence of diabetes mellitus (DM) varies from 1.2 to 13.3% in the general population. The most frequent is type 2 (non-insulin-dependent) DM, which constitutes 90-95% of all cases. DM increases the risk of cardiac disease, stroke, retinopathy, nephropathy, neuropathy and gangrene, and the disease is associated with an increased prevalence of other cardiovascular risk factors such as hypertension, hypercholesterolaemia, asymptomatic carotid artery disease, and obesity. The risk of stroke may be directly and indirectly increased by the presence of DM. Epidemiological data show that DM independently amplifies the risk of ischaemic stroke from 1.8- up to 6-fold, so that prevention of cardiovascular risk in diabetics is of utmost importance. The main goal is to control glycaemia, although it has never been shown to be beneficial in stroke patients. Other preventive strategies include antiplatelet treatment. The open-label Primary Prevention Project trial tested the efficacy of low-dose acetylsalicylic acid (ASA) in prevention of ischaemic events in high-risk patients, but failed to demonstrate a significant benefit of ASA in diabetic patients. However, in the CAPRIE trial, the benefit of clopidogrel was amplified in patients with DM versus those without DM in preventing ischaemic events. This difference was even more striking when comparing patients treated with insulin versus non-diabetics. Another trial -- MATCH -- tested the benefit of adding ASA to clopidogrel versus clopidogrel alone in the prevention of ischaemic events in high-risk cerebrovascular patients, two-thirds of whom had DM. Further research is needed to clarify the effects of different antiplatelet regimens in stroke prevention in diabetic patients, who should be considered as high vascular-risk patients.
Mots-clé
Diabetes Mellitus/epidemiology, Humans, Incidence, Platelet Aggregation Inhibitors/therapeutic use, Risk Factors, Stroke/drug therapy, Stroke/epidemiology
Pubmed
Création de la notice
19/11/2007 13:33
Dernière modification de la notice
20/08/2019 14:22
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