title: Predictors of stroke in patients with impaired glucose tolerance: results from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research trial.
abstract: OBJECTIVE
  Risk factors for stroke are well-established in general populations but sparsely studied in individuals with impaired glucose tolerance.
  
  
  METHODS
  We identified predictors of stroke among participants with impaired glucose tolerance in the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Cox proportional-hazard regression models were constructed using baseline variables, including the 2 medications studied, valsartan and nateglinide.
  
  
  RESULTS
  Among 9306 participants, 237 experienced a stroke over 6.4 years. Predictors of stroke included classical risk factors such as existing cerebrovascular and coronary heart disease, higher pulse pressure, higher low-density lipoprotein cholesterol, older age, and atrial fibrillation. Other factors, including previous venous thromboembolism, higher waist circumference, lower estimated glomerular filtration rate, lower heart rate, and lower body mass index, provided additional important predictive information, yielding a C-index of 0.72. Glycemic measures were not predictive of stroke. Variables associated with stroke were similar in participants with no prior history of cerebrovascular disease at baseline.
  
  
  CONCLUSIONS
  The most powerful predictors of stroke in patients with impaired glucose tolerance included a combination of established risk factors and novel variables, such as previous venous thromboembolism and elevated waist circumference, allowing moderately effective identification of high-risk individuals.
authors.affiliation: University of Glasgow, Glasgow, UK. david.preiss@glasgow.ac.uk
authors.forename: David
authors.initials: D
authors.lastname: Preiss
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Giles
authors.forename: Laine E
authors.initials: LE
authors.lastname: Thomas
authors.forename: Jie-Lena
authors.initials: JL
authors.lastname: Sun
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.forename: Rury R
authors.initials: RR
authors.lastname: Holman
authors.forename: Eberhard
authors.initials: E
authors.lastname: Standl
authors.forename: Theodore
authors.initials: T
authors.lastname: Mazzone
authors.forename: Guy E
authors.initials: GE
authors.lastname: Rutten
authors.forename: Gianni
authors.initials: G
authors.lastname: Tognoni
authors.forename: Fu-Tien
authors.initials: FT
authors.lastname: Chiang
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.forename: Robert M
authors.initials: RM
authors.lastname: Califf
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015897:Comorbidity; D018849:Controlled Clinical Trials as Topic; D003510:Cyclohexanes / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077715:Nateglinide; D017063:Outcome Assessment, Health Care; D010649:Phenylalanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013777:Tetrazoles / Q000627:therapeutic use*; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D003510:Cyclohexanes; D007004:Hypoglycemic Agents; D013777:Tetrazoles; D000077715:Nateglinide; D010649:Phenylalanine; D000068756:Valsartan; D014633:Valine
keywords: impaired glucose tolerance; stroke