From a total of 211 patients recruited, 111 (52.6%) had stroke and 100 (47.4%) had acute coronary syndrome.
Socio-demographic characteristics of study population
The median age was 58 (IQR: 49-68) years. Of the total participants 152/211 (72.0%) were males.
Overall, 144 (68.2%) of the patients were of African origin. The median weight and height of the patients were 78 (IQR: 70-87) Kgs and 169 (IQR: 165-173) cm respectively
|
Diabetes status
|
|
Variable
|
Overall, N = 2111
|
Normal, N = 671
|
Pre-diabetes, N = 641
|
Diabetes, N = 801
|
p-value2
|
Gender, n (%)
|
|
|
|
|
0.065
|
Male
|
152 (72.0)
|
44 (65.7)
|
43 (67.2)
|
65 (81.2)
|
|
Female
|
59 (28.0)
|
23 (34.3)
|
21 (32.8)
|
15 (18.8)
|
|
Age in years, Median (IQR)
|
58 (49 – 68)
|
56 (42 – 64)
|
64 (53 – 71)
|
60 (51 – 67)
|
0.006
|
Ethnicity, n (%)
|
|
|
|
|
0.003
|
African
|
144 (68.2)
|
44 (65.7)
|
47 (73.4)
|
53 (66.2)
|
|
Asian
|
43 (20.4)
|
8 (11.9)
|
12 (18.8)
|
23 (28.7)
|
|
Caucasian
|
24 (11.4)
|
15 (22.4)
|
5 (7.8)
|
4 (5.0)
|
|
Weight in Kgs, Median (IQR)
|
78 (70 – 87)
|
79 (69 – 90)
|
77 (70 – 86)
|
78 (73 – 85)
|
0.700
|
Height in cms, Median (IQR)
|
169 (165 – 173)
|
170 (165 – 174)
|
168 (165 – 172)
|
169 (165 – 172)
|
0.400
|
1Median (IQR) or Frequency (%)
|
2Pearson's Chi-squared test; Kruskal-Wallis rank sum test
|
Table 1
Clinical Characteristics
In the study population 67/211 (31.8%) had no diabetes, 64(30.3%) had pre-diabetes and 80 (37.9%) had diabetes. The average duration of patients with known diabetes presenting with cardiovascular disease was 6 years. From the study population, 30 (14.3%) had previous history of stroke and 42 (19.9%) had previous myocardial infarction. The prevalence of hypertension was 64.9% (n=137). From the total population n = 147 (69.6%) fell into the obese and overweight categories.
|
Diabetes status
|
|
Variable
|
Overall, N = 2111
|
Normal, N = 672
|
Pre-diabetes, N = 642
|
Diabetes, N = 802
|
p-value3
|
Stroke, n (%)
|
|
|
|
|
0.800
|
Ischemic
|
96 (86.5)
|
36 (83.7)
|
31 (88.6)
|
29 (87.9)
|
|
Hemorrhagic
|
15 (13.5)
|
7 (16.3)
|
4 (11.4)
|
4 (12.1)
|
|
Acute Coronary syndrome, n (%)
|
|
|
|
|
0.200
|
Unstable Angina
|
6 (5.6)
|
0 (0.0)
|
2 (6.1)
|
4 (8.3)
|
|
NSTEMI
|
56 (52.3)
|
11 (42.3)
|
21 (63.6)
|
24 (50.0)
|
|
STEMI
|
45 (42.1)
|
15 (57.7)
|
10 (30.3)
|
20 (41.7)
|
|
Previous cardiovascular event: stroke, n (%)
|
30 (14.2)
|
10 (14.9)
|
8 (12.5)
|
12 (15.0)
|
0.900
|
Previous cardiovascular event: Myocardial Infarction, n (%)
|
42 (19.9)
|
9 (13.4)
|
7 (10.9)
|
26 (32.5)
|
0.002
|
Previous cardiovascular event: None, n (%)
|
139 (65.9)
|
47 (70.1)
|
50 (78.1)
|
42 (52.5)
|
0.004
|
Hypertension, n (%)
|
|
|
|
|
0.999
|
Yes
|
137 (64.9)
|
36 (53.7)
|
42 (65.6)
|
59 (73.8)
|
|
No
|
0 (0.0)
|
0 (0.0)
|
0 (0.0)
|
0 (0.0)
|
|
Don't know
|
0 (0.0)
|
0 (0.0)
|
0 (0.0)
|
0 (0.0)
|
|
Cigarette smoking, n (%)
|
|
|
|
|
0.800
|
Never
|
173 (82.0)
|
55 (82.1)
|
54 (84.4)
|
64 (80.0)
|
|
Current
|
24 (11.4)
|
8 (11.9)
|
5 (7.8)
|
11 (13.8)
|
|
Previous
|
14 (6.6)
|
4 (6.0)
|
5 (7.8)
|
5 (6.2)
|
|
Duration of diabetes if known (years), Median (IQR)
|
0 (0 – 7)
|
0 (0 – 0)
|
0 (0 – 0)
|
6 (0 – 10)
|
<0.001
|
Wall motion Abnormalities, n (%)
|
|
|
|
|
0.064
|
Akinesia
|
18 (8.5)
|
8 (11.9)
|
4 (6.2)
|
6 (7.5)
|
|
Hypokinesia
|
64 (30.3)
|
14 (20.9)
|
17 (26.6)
|
33 (41.2)
|
|
Normal kinesia
|
129 (61.1)
|
45 (67.2)
|
43 (67.2)
|
41 (51.2)
|
|
Table 2
Prevalence of dysglycemia
The prevalence of dysglycemia was 68.2% (95% CI: 61.5%-74.5%) with the prevalence of pre-diabetes being 64 (30.3%) and of type 2 diabetes 80 (37.9%). Of the patients with dysglycemia, n=69 (47.9%) had a new diagnosis. Dysglycemia was higher in males (71.1%), Asians (81.4%), patients with hypertension (73.7%), current smokers (71.4%) and over-weight patients (74.7) than other categories in each of the variables. Dysglycemia was significant associated with ethnicity and history of hypertension. There was also significant difference in age, triglycerides and HDL cholesterol between the non-diabetes and dysglycemia groups (Table 7).
|
|
Presence of Diabetes
|
|
Variable
|
Categories
|
Non-diabetic n (%)
|
Dysglycemia n (%)
|
P-value
|
|
Total
|
67 (31.8)
|
144 (68.2)
|
|
Gender
|
Male
|
44 (28.9)
|
108 (71.1)
|
0.188
|
|
Female
|
23(39.0)
|
36 (61.0)
|
|
Age
|
Median (IQR)
|
56.0 (42.0-64.0)
|
61.0 (51.8-70.2)
|
0.002
|
Ethnicity
|
African
|
44 (30.6)
|
100 (68.5)
|
0.001
|
|
Asian
|
8 (18.6)
|
35 (81.4)
|
|
|
Caucasian
|
15 (62.5)
|
9 (37.5)
|
|
Weight (Kgs)
|
Median (IQR)
|
79.0 (69.2-89.5)
|
78.0 (70.0-85.4)
|
0.988
|
Height (cm)
|
Median (IQR)
|
170.0 (165.0-174.0)
|
168.5 (165.0-172.0)
|
0.192
|
Previous stroke
|
No
|
57 (31.5)
|
124 (68.5)
|
0.835
|
|
Yes
|
10 (33.3)
|
20 (66.7)
|
|
Previous MI
|
No
|
58 (34.3)
|
111 (67.7)
|
0.138
|
|
Yes
|
9 (38.1)
|
33 (61.9)
|
|
Previously no condition
|
No
|
20 (27.8)
|
52 (72.2)
|
0.438
|
|
Yes
|
47 (33.8)
|
92 (66.2)
|
|
Hypertension
|
No
|
31 (41.9)
|
43 (58.1)
|
0.030
|
|
Yes
|
36 (26.3)
|
101 (73.7)
|
|
Cigarette smoking
|
Never
|
55 (31.8)
|
118 (68.2)
|
0.999
|
|
Current
|
8 (33.3)
|
16 (71.4)
|
|
|
Previous
|
4 (28.6)
|
10 (35.7)
|
|
Creatinine
|
Median (IQR)
|
88.0 (68.0-106.5)
|
80.5 (58.5-98.2)
|
0.072
|
Total cholesterol
|
Median (IQR)
|
4.4 (3.2-5.5)
|
4.2 (3.4-5.5)
|
0.920
|
Total cholesterol
|
≤ 5.18
|
47 (32.9)
|
96 (67.1)
|
0.639
|
|
>5.18
|
20 (29.4)
|
48 (70.6)
|
|
LDL Cholesterol
|
Median (IQR)
|
2.9 (2.0-3.7)
|
2.9 (1.9-3.9)
|
0.994
|
LDL Cholesterol
|
≤ 2.6
|
28 (30.8)
|
63 (69.2)
|
0.881
|
|
>2.6
|
39 (32.5)
|
81 (67.5)
|
|
Triglycerides
|
Median (IQR)
|
1.0 (0.8-1.6)
|
1.6 (1.0-2.0)
|
0.001
|
Ejection fraction
|
Median (IQR)
|
55.0 (45.0-60.0)
|
55.0 (45.0-60.0)
|
0.246
|
HDL Cholesterol
|
Median (IQR)
|
1.1 (0.9-1.5)
|
1.0 (0.8-1.2)
|
0.002
|
Wall motion Abnormalities
|
Akinesia
|
8 (44.4)
|
10 (55.6)
|
0.081
|
|
Hypokinesia
|
14 (21.9)
|
50 (78.1)
|
|
|
Normal kinesia
|
45 (34.9)
|
84 (65.1)
|
|
BMI
|
Healthy
|
27 (42.2)
|
37 (57.8)
|
0.080
|
|
Over-weight
|
23 (25.3)
|
68 (74.7)
|
|
|
Obesity
|
17 (30.4)
|
39 (69.6)
|
|
Table 3 Bivariate analysis of factors associated with diabetes, N=211