Table of Contents Author Guidelines Submit a Manuscript
Stroke Research and Treatment
Volume 2018, Article ID 4812712, 11 pages
https://doi.org/10.1155/2018/4812712
Research Article

Determining the Joint Effect of Obesity and Diabetes on All-Cause Mortality and Cardiovascular-Related Mortality following an Ischemic Stroke

1Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
2Department of Health Informatics, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA
3Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC, USA
4Department of Nursing, Medical University of South Carolina, Charleston, SC, USA

Correspondence should be addressed to Colleen Bauza; ude.imhj@1azuabc

Received 20 December 2017; Accepted 25 June 2018; Published 9 August 2018

Academic Editor: David Vaudry

Copyright © 2018 Colleen Bauza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although obesity and diabetes mellitus, or diabetes, are independently associated with mortality-related events (e.g., all-cause mortality and cardiovascular-related mortality) following an ischemic stroke, little is known about the joint effect of obesity and diabetes on mortality-related events following an ischemic stroke. The aim of this study is to evaluate the joint effect of obesity and diabetes on mortality-related events in subjects with a recent ischemic stroke. Data from the multicenter Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial was analyzed for this study. The joint effect of obesity and diabetes on mortality-related events was estimated via Cox proportional hazards regression models. No difference in the hazard of all-cause mortality following an ischemic stroke was observed between obese subjects with diabetes and underweight/normal-weight subjects without diabetes. In contrast, obese subjects with diabetes had an increased hazard of cardiovascular-related mortality following an ischemic stroke compared with underweight/normal-weight subjects without diabetes. Additionally, there was evidence of an attributable proportion due to interaction as well as evidence of a highly statistically significant interaction on the multiplicative scale for cardiovascular-related mortality. In this clinical trial cohort of ischemic stroke survivors, obesity and diabetes synergistically interacted to increase the hazard of cardiovascular-related mortality.