ArticleClinical research in cardiology : official journal of the German Cardiac Society2025
Prediabetes in acute stroke: prevalence and impact on early clinical outcomes.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Covert macrovascular disease and early outcome after ischemic cerebrovascular events.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
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Authors and funding
11 authors.
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Abstract
aimsWe aimed to characterize the burden of dysglycemia in acute stroke and evaluate whether HbA₁c, even below the diabetic threshold, is associated with neurological severity and embolic risk.
methodsWe conducted a prospective study of patients with ischemic stroke or transient ischemic attack (TIA) over six months at a German stroke center. Glycemic status was defined by glycated hemoglobin (HbA₁c) and fasting glucose per American Diabetes Association (ADA) criteria. Associations with stroke subtype, age, sex, and severity were analyzed.
resultsAbnormal glucose metabolism was present in 449 of 714 patients (62.9%), including 236 with prediabetes (33.1%) and 213 with diabetes (29.8%). Dysglycemia was most frequent in lacunar (34/40, 85.0%), atherosclerotic stroke (77/110, 70.0%), and cryptogenic strokes (68/ 98, 69.4%). Prediabetes peaked at age 75-84 (r = 0.21; 95% CI, 0.07-0.34; p = 0.0026) and was highest in men ≥ 85 years (51.7% vs. 15.4%). Height of HbA₁c significantly correlated with stroke severity (r = 0.54; 95% CI, 0.43-0.63; p < 10⁻
conclusionPrediabetes is highly prevalent across all stroke entities and independently associated with worse neurological outcomes. HbA₁c may serve as a clinical marker for risk stratification even below diabetic thresholds. Early detection and subsequent intervention may improve stroke outcomes; however, whether prediabetes constitutes a modifiable risk factor remains to be determined in future interventional studies.
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