Abstract Details

Title Metformin Use and Stroke Risk in Hispanic and Non-Hispanic Diabetic Male Veterans

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 1-001

Objective

We investigated the association between Metformin use and incidence of all-cause stroke in the United States Veteran Affairs Electronic Medical Record during 2004-2012 and explored differences by race/ethnicity.

Background Metformin is an established antidiabetic medication with reported additional beneficial health properties, and pharmacological studies suggest differential responses to its use by race/ethnicity. Metformin has been related to reduced stroke risk and stroke severity in European and Asian populations, but little is known about the association between Metformin use and stroke risk in Hispanic populations. We investigated the effect of Metformin at reducing the risk of stroke between Hispanic and non-Hispanic (White and Black) diabetic men seeking medical care at the Veteran Affairs Health Care System.

Design/Methods The study cohort included male US veterans with type 2 diabetes ≥65 years old, insulin/ thiazolidinediones naïve, without stroke history. Stroke incidence was identified by ICD9 codes 430-438 from inpatient/outpatient visits every year over an eight-year period. Generalized estimation equation models were used to compare the odds ratio (OR) of stroke incidence associated with Metformin use over time between race/ethnicity groups. We used inverse propensity score weighting of Metformin use, where propensity scores were predicted by age, HbA1c, Charlson comorbidity score, BMI, LDL, and statin use.

Results From a total of 23,452 diabetic men (6% Hispanic), metformin use was seen in 26.7% (33.8% in Hispanics, 26.3% in non-Hispanics). The likelihood of stroke events over time was OR=1.05 for non-Hispanics and OR=1.17 for Hispanics (p-value=0.24 for difference). We found that Metformin use attenuated the increased OR associated with time on stroke risk by 28% in Hispanics compared to non-Hispanics (p-value=0.02).

Conclusions Our study suggests that Metformin may be more effective in reducing stroke risk among men of Hispanic compared to non-Hispanic race/ethnicity. Further studies could help elucidate putative biological or pharmacological mechanism for this difference.

Authors/Disclosures
Eliana Vasquez (Biggs Institute) PRESENTER	Ms. Vasquez has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Sudha Seshadri, MD, FAAN (Glenn Biggs Institute for Alzheimer'S and Neurodegenerative Diseases)	Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Seshadri has received research support from NIH. The institution of Dr. Seshadri has received research support from Alzheimer Association.
Claudia L. Satizabal, PhD (UT Health San Antonio)	The institution of Dr. Satizabal has received research support from NIH and TARCC.
	No disclosure on file

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