İskemik İnmeli ve Diyabeti Olan Hastaların Demografik, Klinik ve Radyolojik Özelliklerinin Değerlendirilmesi

Abstract

İskemik inme, dünya çapında sakatlık ve mortalitenin yaygın nedenlerinden biridir ve gelişmekte olan ülkelerde görülme sıklığı artmaktadır. Tip 2 diyabet, akut iskemik inme için iyi tanımlanmış bir risk faktörüdür. Diyabetin iskemik inme sonrası mortalite ve kötü klinik sonuçla ilişkili olduğu tahmin edilmektedir. Diyabet ve iskemik inme halk sağlığı sorunlarıdır. Bu çalışmanın amacı toplumumuzdaki diyabetli akut iskemik inme hastalarının demografik klinik ve radyolojik özelliklerini belirlemek ve diyabetli hastalarda iskemik inme rekürrensini etkileyen faktörleri belirlemektir. Bu çalışmada 2019-2021yılları arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Nöroloji bölümünde iskemik inme tanısı alan 862 hasta değerlendirildi. Hastaların demografik, klinik ve radyolojik özellikleri kaydedildi. Diyabetik olan ve olmayan hastaların iskemik inme rekürrensine etki eden faktörler sorgulandı. Bu çalışmada diyabetli akut iskemik inme hastalarında koroner arter hastalığı (p<0.01), hipertansiyon (p<0.01) gibi risk faktörlerinin daha sık görüldüğü, diyabeti olan iskemik inme hastalarda diyabeti olmayanlara göre daha sık iskemik inme rekürrensi (p=0.003) görüldüğü belirlendi. Diyabetli iskemik inme hastalarında iskemik inme rekürrensi olan ve olmayan hastalar kıyaslandığında, iskemik inme rekürrensi ile internal karotid arterde semptomatik aterosklerotik stenoz (p=0.002), anterior sirkülasyon inmesi (p<0.01), büyük damar aterosklerozuna bağlı iskemik inme (p=0.029) ve kötü klinik sonlanım (p=0.016) arasında anlamlı istatistiksel ilişki saptandı. Diyabetli hastalarda glisemik kontrolün prognoza ve iskemik inme rekürrensine etkisi belirlenmedi. Diyabetik hastalarda glisemik kontrolün inme rekürrensi ile ilişkisini belirlemek için çok merkezli prospektif çalışmaların yapılmasını öneriyoruz.

Keywords

• Tip 2 diyabet
• iskemik inme
• glisemik kontrol
• Hba1C
• aterosklerotik damar hastalığı

Evaluation of Demographic, Clinical, and Radiological Characteristics of Patients with Diabetes in Ischemic Stroke Patients

Abstract

Ischemic stroke is a common cause of disability and mortality worldwide, and its incidence is increasing in developing countries. Type 2 diabetes is a well-established risk factor for acute ischemic stroke. Diabetes is predicted to be associated with mortality and poor clinical outcomes after ischemic stroke. Diabetes and ischemic stroke are public health problems. This study aims to determine the demographic, clinical, and radiological characteristics of acute ischemic stroke patients with diabetes in our society and to determine the factors affecting ischemic stroke recurrence in patients with diabetes. This study evaluated 862 patients diagnosed with ischemic stroke in Bursa Uludağ University Faculty of Medicine Neurology between 2019 and 2021. Demographic, clinical, and radiological characteristics of the patients were recorded. Factors affecting ischemic stroke recurrence in diabetic and non-diabetic patients were questioned. In this study, risk factors such as coronary artery disease (p<0.01) and hypertension (p<0.01) were observed more frequently in acute ischemic stroke patients with diabetes, and ischemic stroke patients with diabetes had ischemic stroke recurrence (p=0.003) more often than those without diabetes. Variables associated with ischemic stroke recurrence in ischemic stroke patients with diabetes are; symptomatic atherosclerotic stenosis in the internal carotid artery (p=0.002), anterior circulation stroke (p<0.01), ischemic stroke due to extensive vessel atherosclerosis (p=0.029), and poor clinical outcome (p=0.016). The effect of glycemic control on prognosis and ischemic stroke recurrence in patients with diabetes could not be determined. We recommend that multicenter prospective studies be conducted to determine the relationship between glycemic control and stroke recurrence in diabetic patients.

Keywords

• Type 2 diabetes
• ischemic stroke
• glycemic control
• Hba1C
• atherosclerotic vascular disease

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