Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon

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dc.contributor.authorBalti, Eric Vounsiaen_ZA
dc.contributor.authorKengne, André Pascalen_ZA
dc.contributor.authorFokouo, Jean Valentin Foghaen_ZA
dc.contributor.authorNouthé, Brice Eniden_ZA
dc.contributor.authorSobngwi, Eugeneen_ZA
dc.date.accessioned2016-01-11T06:56:14Z
dc.date.available2016-01-11T06:56:14Z
dc.date.issued2013en_ZA
dc.description.abstractBackground and Purpose: Determinants of post-acute stroke outcomes in Africa have been less investigated. We assessed the association of metabolic syndrome (MetS) and insulin resistance with post-stroke mortality in patients with first-ever-in-lifetime stroke in the capital city of Cameroon (sub-Saharan Africa). METHODS: Patients with an acute first-stroke event (n = 57) were recruited between May and October 2006, and followed for 5 years for mortality outcome. MetS definition was based on the Joint Interim Statement 2009, insulin sensitivity/resistance assessed via glucose-to-insulin ratio, quantitative insulin sensitivity check index and homeostatic model assessment. RESULTS: Overall, 24 (42%) patients deceased during follow-up. The prevalence of MetS was higher in patients who died after 28 days, 1 year and 5 years from any cause or cardiovascular-related causes (all p≤ 0.040). MetS was associated with an increased overall mortality both after 1 year (39% vs. 9%) and 5 years of follow-up (55% vs. 26%, p  = 0.022). Similarly, fatal events due to cardiovascular-related conditions were more frequent in the presence of MetS both 1 year (37% vs. 9%) and 5 years after the first-ever-in-lifetime stroke (43% vs. 13%, p  = 0.017). Unlike biochemical measures of insulin sensitivity and resistance (non-significant), in age- and sex-adjusted Cox models, MetS was associated with hazard ratio (95% CI) of 2.63 (1.03-6.73) and 3.54 (1.00-12.56) respectively for all-cause and cardiovascular mortality 5 years after stroke onset. CONCLUSION: The Joint Interim Statement 2009 definition of MetS may aid the identification of a subgroup of black African stroke patients who may benefit from intensification of risk factor management.en_ZA
dc.identifier.apacitationBalti, E. V., Kengne, A. P., Fokouo, J. V. F., Nouthé, B. E., & Sobngwi, E. (2013). Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon. <i>PLoS One</i>, http://hdl.handle.net/11427/16310en_ZA
dc.identifier.chicagocitationBalti, Eric Vounsia, André Pascal Kengne, Jean Valentin Fogha Fokouo, Brice Enid Nouthé, and Eugene Sobngwi "Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/16310en_ZA
dc.identifier.citationBalti, E. V., Kengne, A. P., Fokouo, J. V., Nouthé, B. E., & Sobngwi, E. (2013). Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon. PloS one, 8(4), e60117. doi:10.1371/journal.pone.0060117en_ZA
dc.identifier.ris TY - Journal Article AU - Balti, Eric Vounsia AU - Kengne, André Pascal AU - Fokouo, Jean Valentin Fogha AU - Nouthé, Brice Enid AU - Sobngwi, Eugene AB - Background and Purpose: Determinants of post-acute stroke outcomes in Africa have been less investigated. We assessed the association of metabolic syndrome (MetS) and insulin resistance with post-stroke mortality in patients with first-ever-in-lifetime stroke in the capital city of Cameroon (sub-Saharan Africa). METHODS: Patients with an acute first-stroke event (n = 57) were recruited between May and October 2006, and followed for 5 years for mortality outcome. MetS definition was based on the Joint Interim Statement 2009, insulin sensitivity/resistance assessed via glucose-to-insulin ratio, quantitative insulin sensitivity check index and homeostatic model assessment. RESULTS: Overall, 24 (42%) patients deceased during follow-up. The prevalence of MetS was higher in patients who died after 28 days, 1 year and 5 years from any cause or cardiovascular-related causes (all p≤ 0.040). MetS was associated with an increased overall mortality both after 1 year (39% vs. 9%) and 5 years of follow-up (55% vs. 26%, p  = 0.022). Similarly, fatal events due to cardiovascular-related conditions were more frequent in the presence of MetS both 1 year (37% vs. 9%) and 5 years after the first-ever-in-lifetime stroke (43% vs. 13%, p  = 0.017). Unlike biochemical measures of insulin sensitivity and resistance (non-significant), in age- and sex-adjusted Cox models, MetS was associated with hazard ratio (95% CI) of 2.63 (1.03-6.73) and 3.54 (1.00-12.56) respectively for all-cause and cardiovascular mortality 5 years after stroke onset. CONCLUSION: The Joint Interim Statement 2009 definition of MetS may aid the identification of a subgroup of black African stroke patients who may benefit from intensification of risk factor management. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0060117 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon TI - Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon UR - http://hdl.handle.net/11427/16310 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16310
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0060117
dc.identifier.vancouvercitationBalti EV, Kengne AP, Fokouo JVF, Nouthé BE, Sobngwi E. Metabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroon. PLoS One. 2013; http://hdl.handle.net/11427/16310.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2013 Balti et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherDeath ratesen_ZA
dc.subject.otherIschemic strokeen_ZA
dc.subject.otherCholesterolen_ZA
dc.subject.otherInsulinen_ZA
dc.subject.otherInsulin resistanceen_ZA
dc.subject.otherStrokeen_ZA
dc.subject.otherMetabolic disordersen_ZA
dc.subject.otherBlood pressureen_ZA
dc.titleMetabolic syndrome and fatal outcomes in the post-stroke event: a 5-year cohort study in Cameroonen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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