Fig. 1-
Fig. 2-
Figure. 3-
Characteristics of patients, including demographic and clinical characteristics according to different TOAST subtypes
| Variables | All patients | Large artery atherosclerosis type | Cardioembolic type | Small vessel occlusive type | Other determined | Undetermined | p value |
|---|---|---|---|---|---|---|---|
| Men | 383(74) | 144(80.9) | 55(64) | 118(76.1) | 18(66.7) | 48(66.7) | 0.017 |
| Age | |||||||
| means±SD | 56.4±14.4 | 59.6±12.7 | 59±16.6 | 54.2±12.7 | 41.5±13.0 | 55.7±15.5 | <0.001 |
| median (IQR) | 56(46–66) | 58(50–69) | 60(45.7–74.2) | 52.5(44–62) | 40(34–48.7) | 58(42–67) | |
| Diabetes mellitus | 347(67) | 143(80.3) | 51(59.3) | 102(65.8) | 6(22.2) | 45(62.5) | <0.001 |
| Hypertension | 344(66.4) | 139(78.1) | 49(57) | 102(65.8) | 13(48.1) | 41(56.9) | <0.001 |
| IHD | 108(20.8) | 31(17.4) | 42(48.8) | 22(14.2) | 3(11.1) | 10(13.9) | <0.001 |
| Dyslipidemia | 254(49) | 97(54.5) | 41(47.7) | 74(47.7) | 9(33.3) | 33(45.8) | 0.26 |
| Previous stroke/TIA | 92(17.8) | 46(25.8) | 12(14) | 18(11.6) | 6(22.2) | 10(13.9) | 0.008 |
| Smoking | 135(26.1) | 52(29.2) | 20(23.3) | 42(27.1) | 7(25.9) | 14(19.4) | 0.55 |
| Arrived within therapeutic window | 235(45.4) | 61(34.3) | 55(64) | 71(45.8) | 13(48.1) | 35(48.6) | <0.001 |
| NIHSS | |||||||
| means±SD | 7.7±5.9 | 8.8±6.2 | 10.3±6.8 | 4.8±3.1 | 8.1±5.3 | 8.5±6.2 | <0.001 |
| median (IQR) | 6(3–10) | 7(4–13) | 9(4–16) | 4(3–7) | 7(3–12) | 7(3.2–12) | |
| Hyperacute treatment | 158(30.5) | 49(27.5) | 35(40.7) | 35(22.6) | 13(48.1) | 26(36.1) | 0.004 |
| Territorial anterior circulation infarct | 46(8.9) | 25(14) | 12(14) | 0 | 5(18.5) | 4(5.6) | <0.001 |
| Partial anterior circulation infarct | 202(39) | 90(50.6) | 58(67.4) | - | 12(44.4) | 40(55.6) | <0.001 |
| Posterior circulation infarct | 97(18.7) | 51(28.7) | 14(16.3) | - | 8(29.6) | 22(30.6) | <0.001 |
| Lacunar infarct | 168(32.4) | 9(5.1) | - | 155(100) | 4(5.6) | <0.001 | |
| HbA1c | |||||||
| means±SD | 7.9±2.5 | 8.69±2.6 | 7.23±2.3 | 7.86±2.3 | 6.30±1.6 | 7.70±2.5 | <0.001 |
| median (IQR) | 7.1(5.9–9.7) | 8.15(6.5–10.9) | 6.4(5.6–8.3) | 7.1(5.9–9.9) | 5.8(5.4–6) | 6.9(5.7–9.4) | |
| Poor functional recovery | 181(35) | 85(47.8) | 41(47.7) | 24(15.5) | 6(22.2) | 25(34.7) | <0.001 |
| Good functional recovery | 337(65) | 93(52.2) | 45(52.3) | 131(84.5) | 21(77.8) | 47(65.3) | <0.001 |
Distribution of demographic and other clinical variables including HbA1c levels between patients with good and poor functional recovery
| Variable (n) | Good functional recovery | Poor functional recovery | *Odds Ratio | 95% confidence interval | P value |
|---|---|---|---|---|---|
| Age (mean±SD) | 54.5±14.07 | 60±14.49 | - | <0.001 | |
| Male (383) | 254 (75.3) | 129 (71.3) | 0.87 | 0.67–1.13 | 0.34 |
| Hypertension (344) | 212 (62.9) | 132 (72.9) | 1.36 | 1.03–1.78 | 0.02 |
| Diabetes mellitus (347) | 213 (63.2) | 134 (74) | 1.40 | 1.06–1.85 | 0.012 |
| Ischemic heart disease disease (108) | 61 (18.1) | 47 (26) | 1.33 | 1.03–1.72 | 0.03 |
| Dyslipidemia (254) | 160(47.5) | 94(51.9) | 1.12 | 0.88–1.42 | 0.33 |
| Prior H/O stroke (92) | 46 (13.6) | 46(25.5) | 1.57 | 1.23–2.02 | 0.001 |
| Atrial fibrillation (45) | 20(5.9) | 25(13.8) | 1.83 | 1.36–2.47 | 0.001 |
| NIHSS on presentation (Mean±SD) | 5.31±4.00 | 12.57±6.0 | - | <0.001 | |
| TOAST subtypes | |||||
| Large artery atherosclerosis (178) | 93(27.6) | 85(46.9) | 1.69 | 1.34–2.12 | <0.001 |
| Cardio-embolic (86) | 45(13.4) | 41(22.7) | 1.47 | 1.13–1.90 | 0.007 |
| Small vessel occlusion (155) | 131(38.8) | 24(13.3) | 0.35 | 0.24–0.52 | <0.001 |
| Other determined (27) | 21(6.2) | 06(3.3) | 0.62 | 0.30–1.27 | 0.15 |
| Undetermined (72) | 47(13.9) | 25(13.8) | 0.99 | 0.70–1.39 | 0.96 |
| Territorial anterior circulation infarct (46) | 5(1.5) | 41(22.7) | 3.00 | 2.53–3.56 | <0.001 |
| Partial anterior circulation infarct (202) | 121(35.9) | 81(44.8) | 1.26 | 1.00–1.60 | 0.04 |
| Lacunar infarct (168) | 142(42.1) | 27(14.9) | 0.36 | 0.25–0.52 | <0.001 |
| Posterior circulation infarct (97) | 66(19.6) | 31(17.1) | 0.89 | 0.65–1.23 | 0.49 |
| Hyper acute treatment (158) | 103(30.6) | 55(30.4) | 0.98 | 0.76–1.26 | 0.88 |
| HbA1c (Mean±SD) | 7.57±2.25 | 8.61±2.83 | <0.001 |
Multiple models of Logistic regression analysis for association of HbA1c with poor functional recovery in all patients with acute ischemic stroke
| Variables | Odds ratio | 95% confidence interval | P value |
|---|---|---|---|
| Model 1, adjusted for NIHSS | |||
| HbA1c | 1.29 | 1.17–1.41 | <0.001 |
| NIHSS | 1.32 | 1.25–1.39 | <0.001 |
| Model 2, adjusted for CE subtype | |||
| HbA1c | 1.20 | 1.11–1.29 | <0.001 |
| CE subtype (yes versus no) | 2.30 | 1.41–3.75 | 0.001 |
| Model 3, adjusted for LAA subtype | |||
| HbA1c | 1.14 | 1.06–1.23 | <0.001 |
| LAA subtype (yes versus no) | 2.02 | 1.37–2.98 | <0.001 |
| Model 4, adjusted for SVO subtype | |||
| HbA1c | 1.18 | 1.09–1.27 | <0.001 |
| SVO subtype (yes versus no) | 0.23 | 0.14–0.38 | <0.001 |
| Model 5, adjusted for subtypes associated with poor recovery (LAA and CE) | |||
| HbA1c | 1.16 | 1.08–1.26 | <0.001 |
| LAA | 2.91 | 1.90–4.47 | <0.001 |
| CE | 3.66 | 2.15–6.22 | <0.001 |
| Model 6, Model adjusted for risk factors | |||
| HbA1c | 1.25 | 1.13–1.39 | <0.001 |
| Age | 1.02 | 1.00–1.03 | 0.01 |
| DM | 0.59 | 0.32–1.08 | 0.09 |
| HTN | 1.29 | 0.81–2.04 | 0.27 |
| IHD | 1.48 | 0.91–2.41 | 0.11 |
| AF | 2.52 | 1.26–5.06 | 0.009 |
| Prior stroke | 1.32 | 0.76–2.29 | 0.31 |