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Potential New Horizons for the Prevention of Cerebrovascular Diseases and Dementia
In this issue ofJAMA Neurology, Spence et al discuss the effect of pioglitazone, an insulin-sensitizing agent that has been shown to reduce the risk of recurrent stroke and myocardial infarction in patients with insulin resistance, in patients with prediabetes. Prediabetes was defined according to the American Diabetes Association criteria, ie, a hemoglobin A1c level of 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL. Data were taken from the Insulin Resistance Intervention after Stroke (IRIS) study, an international randomized clinical trial performed in patients with previous stroke or transient ischem...
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research