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(Stroke. 2007;38:398.)
© 2007 American Heart Association, Inc.

Research Reports

Is Diabetic Retinopathy an Independent Risk Factor For Ischemic Stroke?

Ning Cheung, MBBS; Sophie Rogers, Mepi; David J. Couper, PhD; Ronald Klein, MD, MPH; A. Richey Sharrett, MD, DrPH Tien Y. Wong, MD, PhD

From Centre for Eye Research Australia (N.C., S.R., T.Y.W.), University of Melbourne, Australia; Department of Biostatistics (D.J.C.), University of North Carolina, Chapel Hill, NC; Department of Ophthalmology (R.K.), University of Wisconsin, Madison, Wis; Department of Epidemiology (A.R.S.), Johns Hopkins University, Baltimore, Md; Singapore Eye Research Institute (T.Y.W.), National University of Singapore.

Correspondence to Tien Wong, MD, PhD, University of Melbourne, 32 Gisborne Street, Victoria 3002, Australia. E-mail twong{at}unimelb.edu.au

Background and Purpose— The relationship between diabetic retinopathy and ischemic stroke is uncertain and examined in this study.

Methods— A population-based, prospective cohort study of 1617 middle-aged persons with diabetes. Diabetic retinopathy signs were ascertained from retinal photographs, and incident ischemic stroke events were prospectively identified and validated.

Results— Over an average follow-up of 7.8 years, there were 75 ischemic stroke events. After adjustment for age, gender, race, center, 6-year mean arterial blood pressure, anti-hypertensive treatment use, fasting glucose, insulin treatment, duration of diabetes, high-density lipoprotein and low-density lipoprotein cholesterol levels and cigarette smoking status, diabetic retinopathy was associated with an increased risk of ischemic stroke (hazard rate ratio, 2.34; 95% CI, 1.13 to 4.86).

Conclusions— Diabetic retinopathy predicts incident ischemic stroke in people with diabetes, independent of other risk factors.

Key Words: diabetic retinopathy • ischemic stroke

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