Neurotoxicity Research

, Volume 36, Issue 4, pp 836–843 | Cite as

Association of Body Mass Index and Risk of Stroke After Acute Minor Stroke or TIA: a Post Hoc Analysis of a Randomized Controlled Trial

  • Weiqi Chen
  • Yuesong Pan
  • Jing Jing
  • Xingquan Zhao
  • Liping Liu
  • Xia Meng
  • Yilong Wang
  • Yi LinEmail author
  • Yongjun WangEmail author
  • On behalf of the CHANCE Investigators
Original Article


The “obesity paradox” was reported in patients with stroke. We aimed to evaluate the pattern and magnitude of association between body mass index (BMI) and prognosis of stroke in patients with minor ischemic stroke or transient ischemic attack (TIA). A total of 5163 patients with available BMI data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial were included. Patients were classified into three groups according to their BMI values: normal weight (< 23.9 kg/m2), overweight (24–27.9 kg/m2), and obese (≥ 28.0 kg/m2). The efficacy outcomes included a new stroke (ischemic or hemorrhagic), poor functional outcome defined as modified Rankin scale ≥ 2 points and death from any cause within 90 days. The interaction effects were determined using multivariable Cox or logistic regression models. After 90 days of follow up, there were 513 new strokes. Overweight (BMI 24–27.9 kg/m2) patients had a higher risk of recurrent strokes than those with normal weight (10.8% vs 8.8%; HR = 1.24, 95% CI 1.02–1.50) after adjusting for the baseline covariates, but no significant association was observed for those who were obese (P = 0.37). No significant association was found between being overweight or obese and poor functional outcome or death. For patients with a minor ischemic stroke or TIA, being overweight was associated with an increased risk of recurrent stroke compared to being of normal weight in our study.

Trial registration: URL: Unique identifier: NCT00979589.


Body mass index Ischemic stroke Obesity Prognosis Transient ischemic attack 



Body mass index


Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events


Confidence intervals


Interquartile range


Modified Rankin Scale


Transient ischemic attack


National Institutes of Health stroke scale



We appreciated all the patients, relevant clinicians, imaging, and laboratory technicians who participated in the study and many individuals not specifically mentioned in the paper who have supported the study.

Funding Information

This study was supported by the National Natural Science Foundation of China(81870929), grants from National Key Technology Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China (2015BAI12B04 and 2015BAI12B02), a grant from Beijing Municipal Science and Technology Commission (D151100002015001), a grant from Beijing Institute for Brain Disorders (1152130306), Joint Funds of Science and Technology Innovation of Fujian Province (2017Y9086), a grant from Medical Innovation Project for Research Talents of Fujian Province (2018-CX-25), and a grant from Science and Technology Major Project of Fujian Province (2017YZ0001-1).

Compliance with Ethical Standards

The protocol and data collection of the CHANCE trial were approved by ethics committee of Beijing Tiantan Hospital and all other participating hospitals, in compliance with the Declaration of Helsinki. Written informed consent was obtained from all participants or their legal proxies.

Conflict of Interest

The authors declare that there are no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
  2. 2.China National Clinical Research Center for Neurological DiseasesBeijingChina
  3. 3.Center of StrokeBeijing Institute for Brain DisordersBeijingChina
  4. 4.Beijing Key Laboratory of Translational Medicine for Cerebrovascular DiseaseBeijingChina
  5. 5.Department of Neurology and Institute of Neurology, First Affiliated HospitalFujian Medical UniversityFujianChina
  6. 6.Fujian Key Laboratory of Molecular Neurology, Fujian Medical UniversityFuzhouChina

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