{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:45:19Z","timestamp":1775252719330,"version":"3.50.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We aimed to determine the risk conferred by metabolic syndrome (\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              ) and diabetes mellitus (\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              ) to recurrent stroke in patients with minor ischemic stroke or transient ischemic attack from the CHANCE (Clopidogrel in High\u2010risk patients with Acute Non\u2010disabling Cerebrovascular Events) trial.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In total, 3044 patients were included. Patients were stratified into 4 groups: neither,\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              only,\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              only, or both.\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              was defined using the Chinese Diabetes Society (\n              <jats:styled-content style=\"fixed-case\">CDS<\/jats:styled-content>\n              ) and International Diabetes Foundation (\n              <jats:styled-content style=\"fixed-case\">IDF<\/jats:styled-content>\n              ) definitions. The primary outcome was new stroke (including ischemic and hemorrhagic) at 90\u00a0days. A multivariable Cox regression model was used to assess the relationship of\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              status to the risk of recurrent stroke adjusted for potential covariates. Using the\n              <jats:styled-content style=\"fixed-case\">CDS<\/jats:styled-content>\n              criteria of\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              , 53.2%, 17.2%, 19.8%, and 9.8% of patients were diagnosed as neither,\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              only,\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              only, and both, respectively. After 90\u00a0days of follow\u2010up, there were 299 new strokes (293 ischemic, 6 hemorrhagic). Patients with\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              only (16.1% versus 6.8%; adjusted hazard ratio 2.50, 95% CI 1.89\u20133.39) and both (17.1% versus 6.8%; adjusted hazard ratio 2.76, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.98\u20133.86) had significantly increased rates of recurrent stroke. No interaction effect of antiplatelet therapy by different\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              or\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              status for the risk of recurrent stroke (\n              <jats:italic>P<\/jats:italic>\n              =0.82 for interaction in the fully adjusted model of\n              <jats:styled-content style=\"fixed-case\">CDS<\/jats:styled-content>\n              ) was observed. Using the\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              (\n              <jats:styled-content style=\"fixed-case\">IDF<\/jats:styled-content>\n              ) criteria demonstrated similar results.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Concurrent\n              <jats:styled-content style=\"fixed-case\">METS<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\n              was associated with an increased risk of recurrent stroke in patients with minor stroke and transient ischemic attack.\n            <\/jats:p>\n          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