Fibrinolytic parameters under ischemic stroke with diabetes mellitus combination

Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods. This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization. Results. Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group (n = 377), the DM group (n = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, P = 0.001 ), heart failure rehospitalization (37.4% vs. 20.7%, P < 0.001 ), and MACCEs (60.0% vs. 35.8%, P < 0.001 ). After adjustment of confounders by the multivariable cox regression, DM appeared as an independent predictor for MACCEs (adjusted hazard ratio, aHR: 1.88; 95% confidence interval 1.42–2.48; P < 0.001 ). In the subgroup analysis of VHD etiology and functional style, conversely, DM was a protective factor for MACCEs in the patients with rheumatic VHD compared with those without rheumatic VHD (aHR: 0.43 vs. 2.27, P = 0.004 ). Conclusions. DM was an independent predictor for ischemic stroke and heart failure rehospitalization in elderly VHD patients undergoing conservative treatment.

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Nutritional Therapy In Ischemic Stroke Patients With Type 2 Diabetes Mellitus : A Case Report

Smart Medical Journal ◽

10.13057/smj.v3i1.42114 ◽

2020 ◽

Vol 3 (1) ◽

pp. 33

Author(s):

Cipuk Muhaswitri ◽

Diyah Eka Andayani ◽

Taufik Mesiano

Keyword(s):

Diabetes Mellitus ◽

Ischemic Stroke ◽

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Nutritional Therapy ◽

Facial Nerve Paralysis ◽

Stroke Patients ◽

Nerve Paralysis

Introduction: The prevalence of stroke in Indonesia increased from 8.3 per 1000 population in 2007 to 12.1 per 1000 population in 2013, based on Riset Kesehatan Dasar (RISKESDAS) 2013. Diabetes mellitus (DM) is an independent risk factor and can be modified. Hyperglycemia that occurs in the acute phase of stroke is associated with an increase in mortality and poor clinical outcome after stroke. Moreover, stroke patients are at risk of developing hypoalbuminemia due to poor intake and the presence of a chronic inflammatory process. Methods: A 66-year-old female patient with third recurrent ischemic stroke, history of uncontrolled DM, conciousness based on GCS is E3M5Vaphasia, Nasogastric tube (NGT) was inserted and there was a right facial nerve paralysis and bilateral hemiparesis . Nutritional status of patient is obese-1. During follow up period, the patient's blood glucose level ranged from 194 g/dl-345 g/dl. Nutrition therapy is given with a target of 1350 kcal (32 kcal/kg). Its composition consists of 15% protein, 25% fat and 60% carbohydrate (preferred complex carbohydrates), in the form of DM-specific formula containing inulin and monounsaturated fatty acid (MUFA). This nutritional therapy was administrated six times per day via enteral pathway, followed by the administration of micronutrients of vitamins C, B and folic acid. Result: During follow up period, the patient tolerated well with the diet. After the 14 days hospitalization, there was improvement of blood glucose level (<200 g/dL). Albumin level increases from 2.5 g/dL to 2.9 g/dl by the nutritional therapy containing protein more than 1.2 g/kg/day. Conclusion: Administering a diet with the recommended composition and formula helps control hyperglycemia and improve hypoalbuminemia in patients that can improve the patient's clinical condition.

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Correlation of Resistin levels with risk factors in type 2 diabetes mellitus patients with ischemic stroke

MedPulse International Journal of Biochemistry ◽

10.26611/1002931 ◽

2019 ◽

Vol 9 (3) ◽

pp. 63-67

Author(s):

T Rameswari ◽

◽

G Ezhil ◽

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Ischemic Stroke

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Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2

Medica Hospitalia : Journal of Clinical Medicine ◽

10.36408/mhjcm.v6i1.373 ◽

2019 ◽

Vol 6 (1) ◽

pp. 20-23

Author(s):

Aditya Kurnianto ◽

Dodik Tugaswowo Pramukarso

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Ischemic Stroke ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

T Test ◽

Stroke Patients ◽

Media Thickness

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL : Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2

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Gaya Hidup yang Berpengaruh terhadap Kejadian Stroke Iskemik pada Usia Kurang dari 45 Tahun (Studi Pada BLUD RSUD Cut Nyak Dhien Meulaboh Kabupaten Aceh Barat Provinsi Aceh)

Jurnal Epidemiologi Kesehatan Komunitas ◽

10.14710/j.e.k.k.v3i2.4023 ◽

2018 ◽

Vol 3 (2) ◽

pp. 55

Author(s):

Arif Iskandar ◽

Suharyo Hadisaputro ◽

Dwi Pudjonarko ◽

Suhartono Suhartono ◽

Dodik Tugasworo Pramukarso

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Heart Disease ◽

Ischemic Stroke ◽

Life Style ◽

Smoking Habit ◽

Modern Society ◽

Observational Method ◽

High Fat ◽

Stroke Patients

Background: Ischemic stroke that occurs at the age of less than 45 years accounts for about 5 until 10 percent of the total stroke. This is inﬂuenced by changes in the life-style of modern society, such as changes in the pattern of food consumption, lazy to move, and smoking habits. This study aims to examine the effect of life-style on ischemic stroke at less than 45 years old people.Method: This study uses observational method with design of cases and controls. The samples are 86 observations consisting of 43 cases and 43 controls. Cases are patients with ischemic stroke less than 45 years of age and controls are non-stroke patients of neurology who are less than 45 years old.Results: The results show that the habit of consuming food containing high fat (p=0,032, OR=3,744, 95% CI=1,124-12,468) and smoking habit (p=0,019, OR=3.859, 95% CI=1,250-11,911) affect the occurrence of ischemic stroke at age less than 45 years. However, the habit of consuming red meat, consuming foods containing high salt, consuming drugs, and lack of physical activity do not affect the occurrence of ischemic stroke at age less than 45 years.Conclusion: The habits of consuming food containing high fat and smoking affect theoccurrence of ischemic stroke at age less than 45 years after hypertension, heart disease, and diabetes mellitus are controlled.

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