Skip to main content
Erschienen in: Info Diabetologie 6/2022

09.12.2022 | Vorhofflimmern | Zertifizierte Fortbildung

Woran müssen Hausärzte und Diabetologen denken?

Behandlung von Diabetespatienten nach Schlaganfall

verfasst von: Prof. Dr. med. Sebastian Jander

Erschienen in: Info Diabetologie | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

Auszug

Menschen mit Diabetes gehören bereits einer Hochrisikogruppe an. Erleiden sie einen Schlaganfall, ist ihr Risiko für kardiovaskuläre Morbidität und Mortalität nochmals erhöht. Für die behandelnden Ärzte ist nun die Therapie der meist multipel vorliegenden Risikofaktoren wichtig, um erneuten Schlaganfällen vorzubeugen und das kardiovaskuläre Morbiditäts- und Mortalitätsrisiko zu senken.
Literatur
1.
Zurück zum Zitat Adams HP Jr et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24:35-41 Adams HP Jr et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24:35-41
2.
Zurück zum Zitat Hart RG et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13:429-38 Hart RG et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014;13:429-38
3.
Zurück zum Zitat Kang DW et al. Association of ischemic lesion patterns on early diffusion-weighted imaging with TOAST stroke subtypes. Arch Neurol. 2003;60:1730-4 Kang DW et al. Association of ischemic lesion patterns on early diffusion-weighted imaging with TOAST stroke subtypes. Arch Neurol. 2003;60:1730-4
4.
Zurück zum Zitat Sanna T et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014;370:2478-86 Sanna T et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. 2014;370:2478-86
5.
Zurück zum Zitat Johnston SC et al. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. N Engl J Med. 2018;379:215-25 Johnston SC et al. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. N Engl J Med. 2018;379:215-25
6.
Zurück zum Zitat Amarenco P et al. Ticagrelor Added to Aspirin in Acute Ischemic Stroke or Transient Ischemic Attack in Prevention of Disabling Stroke: A Randomized Clinical Trial. JAMA Neurol. 2021;78:177-85 Amarenco P et al. Ticagrelor Added to Aspirin in Acute Ischemic Stroke or Transient Ischemic Attack in Prevention of Disabling Stroke: A Randomized Clinical Trial. JAMA Neurol. 2021;78:177-85
7.
Zurück zum Zitat Johnston SC et al. Time Course for Benefit and Risk of Clopidogrel and Aspirin After Acute Transient Ischemic Attack and Minor Ischemic Stroke. Circulation. 2019;140:658-64 Johnston SC et al. Time Course for Benefit and Risk of Clopidogrel and Aspirin After Acute Transient Ischemic Attack and Minor Ischemic Stroke. Circulation. 2019;140:658-64
8.
Zurück zum Zitat Patti G et al. Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy after Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment. Am J Cardiol. 2019;124(4):627-35 Patti G et al. Meta-Regression to Identify Patients Deriving the Greatest Benefit from Dual Antiplatelet Therapy after Stroke or Transient Ischemic Attack Without Thrombolytic or Thrombectomy Treatment. Am J Cardiol. 2019;124(4):627-35
9.
Zurück zum Zitat SPS3 Investigators. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med. 2012;367:817-25 SPS3 Investigators. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med. 2012;367:817-25
10.
Zurück zum Zitat Ruff CT et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62 Ruff CT et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62
11.
Zurück zum Zitat Rydén et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013;34:3035-87 Rydén et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013;34:3035-87
12.
Zurück zum Zitat Larsson SC et al. Type 2 diabetes, glucose, insulin, BMI, and ischemic stroke subtypes: Mendelian randomization study. Neurology. 2017;89:454-60 Larsson SC et al. Type 2 diabetes, glucose, insulin, BMI, and ischemic stroke subtypes: Mendelian randomization study. Neurology. 2017;89:454-60
13.
Zurück zum Zitat Bosch J et al. Antihypertensives and Statin Therapy for Primary Stroke Prevention: A Secondary Analysis of the HOPE-3 Trial. Stroke. 2021;52:2494-501 Bosch J et al. Antihypertensives and Statin Therapy for Primary Stroke Prevention: A Secondary Analysis of the HOPE-3 Trial. Stroke. 2021;52:2494-501
14.
Zurück zum Zitat The SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015;373: 2103-16 The SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015;373: 2103-16
15.
Zurück zum Zitat Jaeger BC et al. Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. 2022; https://doi.org/10.1001/jamacardio.2022.3345 Jaeger BC et al. Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. 2022; https://​doi.​org/​10.​1001/​jamacardio.​2022.​3345
16.
Zurück zum Zitat Katsanos AH et al. Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials. Hypertension. 2017;69:171-9 Katsanos AH et al. Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials. Hypertension. 2017;69:171-9
17.
Zurück zum Zitat ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575-85 ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575-85
18.
Zurück zum Zitat Bangalore S et al. Optimal Systolic Blood Pressure Target After SPRINT: Insights from a Network Meta-Analysis of Randomized Trials. Am J Med. 2017;130:707-719.e8 Bangalore S et al. Optimal Systolic Blood Pressure Target After SPRINT: Insights from a Network Meta-Analysis of Randomized Trials. Am J Med. 2017;130:707-719.e8
19.
Zurück zum Zitat Hamann GF, Sander D, Röther J, Grau A et al. Deutsche Schlaganfall-Gesellschaft und Deutsche Gesellschaft für Neurologie. Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke: Teil 1, S2kLeitlinie, 2022, in: Deutsche Gesellschaft für Neurologie (Hrsg.), Leitlinien für Diagnostik und Therapie in der Neurologie. Online: www.dgn.org/leitlinien (abgerufen am 16.10.2022) Hamann GF, Sander D, Röther J, Grau A et al. Deutsche Schlaganfall-Gesellschaft und Deutsche Gesellschaft für Neurologie. Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke: Teil 1, S2kLeitlinie, 2022, in: Deutsche Gesellschaft für Neurologie (Hrsg.), Leitlinien für Diagnostik und Therapie in der Neurologie. Online: www.dgn.org/leitlinien (abgerufen am 16.10.2022)
20.
Zurück zum Zitat Nazarzadeh et al. Blood pressure-lowering treatment for prevention of major cardiovascular diseases in people with and without type 2 diabetes: an individual participant-level data meta-analysis. Lancet Diabetes Endocrinol. 2022;10:645-54 Nazarzadeh et al. Blood pressure-lowering treatment for prevention of major cardiovascular diseases in people with and without type 2 diabetes: an individual participant-level data meta-analysis. Lancet Diabetes Endocrinol. 2022;10:645-54
21.
Zurück zum Zitat Amarenco P et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-59 Amarenco P et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549-59
22.
Zurück zum Zitat Callahan A et al. Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Arch Neurol. 2011;68:1245-51 Callahan A et al. Risk of stroke and cardiovascular events after ischemic stroke or transient ischemic attack in patients with type 2 diabetes or metabolic syndrome: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Arch Neurol. 2011;68:1245-51
23.
Zurück zum Zitat Amarenco P et al. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med. 2020;382:9-19 Amarenco P et al. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med. 2020;382:9-19
24.
Zurück zum Zitat Amarenco P et al. Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke. Stroke. 2020;51:1231-9 Amarenco P et al. Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke. Stroke. 2020;51:1231-9
25.
Zurück zum Zitat Mitsios JP et al. Relationship Between Glycated Hemoglobin and Stroke Risk: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2018;7(11):e007858 Mitsios JP et al. Relationship Between Glycated Hemoglobin and Stroke Risk: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2018;7(11):e007858
26.
Zurück zum Zitat Griffin SJ et al. Impact of metformin on cardiovascular disease: a meta-analysis of randomised trials among people with type 2 diabetes. Diabetologia. 2017;0:1620-9 Griffin SJ et al. Impact of metformin on cardiovascular disease: a meta-analysis of randomised trials among people with type 2 diabetes. Diabetologia. 2017;0:1620-9
27.
Zurück zum Zitat Kernan WN et al. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. N Engl J Med. 2016;374:1321-31 Kernan WN et al. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. N Engl J Med. 2016;374:1321-31
28.
Zurück zum Zitat Palmer SC et al. Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2021;372:m 4573 Palmer SC et al. Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2021;372:m 4573
29.
Zurück zum Zitat Gerstein HC et al. The effect of dulaglutide on stroke: an exploratory analysis of the REWIND trial. Lancet Diabetes Endocrinol. 2020;8:106-14 Gerstein HC et al. The effect of dulaglutide on stroke: an exploratory analysis of the REWIND trial. Lancet Diabetes Endocrinol. 2020;8:106-14
30.
Zurück zum Zitat Lim S et al. Diabetes drugs and stroke risk: Intensive versus conventional glucose-lowering strategies, and implications of recent cardiovascular outcome trials. Diabetes Obes Metab. 2020;22:6-15 Lim S et al. Diabetes drugs and stroke risk: Intensive versus conventional glucose-lowering strategies, and implications of recent cardiovascular outcome trials. Diabetes Obes Metab. 2020;22:6-15
Metadaten
Titel
Woran müssen Hausärzte und Diabetologen denken?
Behandlung von Diabetespatienten nach Schlaganfall
verfasst von
Prof. Dr. med. Sebastian Jander
Publikationsdatum
09.12.2022
Verlag
Springer Medizin
Erschienen in
Info Diabetologie / Ausgabe 6/2022
Print ISSN: 1865-5459
Elektronische ISSN: 2196-6362
DOI
https://doi.org/10.1007/s15034-022-4444-7

Weitere Artikel der Ausgabe 6/2022

Info Diabetologie 6/2022 Zur Ausgabe

Praxisempfehlungen der Deutschen Diabetes Gesellschaft

Kurz, prägnant und aktuell: Die Praxisempfehlungen der Deutschen Diabetes Gesellschaft.