Zusammenfassung
Der Diabetes mellitus ist mit einem erhöhten Risiko für zerebrovaskuläre Erkrankungen und einem 2- bis 5fach erhöhten Schlaganfallrisiko verbunden. Parallel dazu ist die Prognose des Schlaganfalls bei Diabetikern deutlich ungünstiger als bei Nichtdiabetikern. Die Ursachen sind komplex und entsprechen dem Risikocluster von Hypertonie, Dyslipoproteinämie und einem prokoagulatorischen Zustand insbesondere beim Typ-2-Diabetes. Entscheidende Bedeutung kommt dabei sowohl dem HbAic-Wert (Kothari et al. 2002) als auch der Dauer der Erkrankung zu. Darüber hinaus dürften bei Diabetes mellitus metabolische Veränderungen für das Risiko einer Infarktausdehnung verantwortlich sein.
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Literatur
Abott RD, Donahue RP, MacMahon SW et al (1987) Diabetes and the risk of stroke. The Honolulu Heart Program. JAMA 257:949–952
Blauw GJ, Lagaay AM, Smelt AHM, Westendorp RGJ (1997) Stroke, statins and cholesterol. A metaanalysis of randomized, placebo-controlled, double-blind trials with HMG-CoA reductase inhibitors. Stroke 28: 946–950
CAPRIE Steering Committee (1996) A randomised, blinded, trial of Clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348: 1329–1339
Davis TME, Millns H, Stratton IM et al (1999) Risk factors for stroke in type 2 diabetes mellitus. United Kingdom Prospective Diabetes Study (UKPDS 29). Arch Intern Med 159:1097–1103
Del Zoppo GJ, Higashida RT, Furlan AJ et al (1996) The prolyse in acute cerebral thromboembolism trial (PROACT): Results of 6 mg dose tier. Stroke 27: 164
Diener HC, Cuhna L, Forbes C et al (1996) European Stroke Prevention Study 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 143: 1–13
EAFT Group (1993) Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 342:1255–1262
Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. (1995) Endarterectomy for asymptomatic carotid artery stenosis. JAMA 273:1421–1428
Furlan A, Higashida R, Wechsler L et al (1999) Intra-arterial prourokinase for acute ischemic stroke — The PROACT II Study: A randomized controlled trial. JAMA 282:2003–2011
Hacke W, Kaste M, Olsen TS et al for the EUSI Executive Committee (2000) Acute treatment of ischemic stroke. Cerebrovasc Dis 10(Suppl 3): 22–33
Hart RG, Halperin JL, McBride R et al (2000) Aspirin for the primary prevention of stroke and other major vascular events. Meta-analysis and hypotheses. Arch Neurol 57:326–332
Heart Outcomes Prevention Evaluation (HOPE) Study Investigators (2000) Effects of ramipril on cardiovascular and microvasular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355: 253–259
International Stroke Trial Collaborative Group (1997) The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19.435 patients with acute ischaemic stroke. Lancet 349: 1564–1565
Kagansky N, Levy S, Knobler H (2001 ) The role of hyperglycemia in acute stroke. Arch Neurol 58: 1209–1212
Klein R, Moss R (1995) A comparison of the study population in the diabetes control and complication trial and a Wisconsin epidemiologic study of diabetic retinopathy. Arch Int Med 155:745–754
Kothari V, Stevens RJ, Adler Al et al (2002) UKPDS 60. Risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 33: 1776–1781
Lehto S, Ronnemaa T, Pyorala K, Laakso M (1996) Predictors of stroke in middle-aged patients with non-insulin dependent diabetes. Stroke 27(1): 63–68
Muller S, Martin S, Koenig W et al (2002) Impaired glucose tolerance is associated with increased serum concentrations of interleukin 6 and co-regulated acute-phase proteins but not TNF-alpha or its receptors. Diabetologia 45:805–812
Neaton JD, Wentworth DN, Cutler J et al (1993) Risk factors for death from different types of stroke. Multiple risk factors for death from different types of stroke. Multiple Risk Factor Intervention Trial Research Group. Ann Epidemiol 3:493–499
Perry HM, Davis BR, Price TR et al (2000) Effect of treating isolated systolic hypertension on the risk of developing various types and subtypes of stroke. The Systolic Hypertension in the Elderly Program (SHEP) JAMA 284:465–471
Progress Collaborative Group (2001) Randomised trial of a perindopril-based blood-pressure lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 358: 1033–1041
Stegmayr B, Asplund K (1995) Diabetes as a risk factor for stroke. A population perspective. Diabetologia 38:1061–1068
UK Prospective Diabetes Study Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). BMJ 317: 703–713
Williams LS, Rotich J, Qi R et al (2002) Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology 59:67–71
Wolf PA, D’Agostino RB, Belanger AJ et al (1991) Prohability of stroke: a risk profile from the Framingham Study Stroke 22: 312–318
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Diener, H.C. (2004). Zerebrale Durchblutungsstörungen. In: Waldhäusl, W.K., Gries, F.A., Scherbaum, W.A. (eds) Diabetes in der Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18571-7_33
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DOI: https://doi.org/10.1007/978-3-642-18571-7_33
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