Medication Adherence of Statin Users after Acute Ischemic Stroke

2018 ◽  
Vol 80 (1-2) ◽  
pp. 106-114 ◽  
Author(s):  
Pil-Wook Chung ◽  
Byung-Woo Yoon ◽  
Yeong-Bae Lee ◽  
Byoung-Soo Shin ◽  
Hahn Young Kim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Medication Adherence ◽  
Acute Ischemic Stroke ◽  
Multiple Logistic Regression Analysis ◽  
Statin Treatment ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Subtype ◽  
Modifiable Factors ◽  
Statin Adherence

Although statins are established therapy for the secondary prevention of ischemic stroke, factors associated with adherence to statin treatment following ischemic stroke are not well known. To address this, we assessed the 6-month statin adherence using 8-item Morisky Medication Adherence Scale-8 in patients with acute ischemic stroke. Of 991 patients, 65.6% were adherent to statin at 6-month after discharge. Multiple logistic regression analysis showed that patients’ awareness of hyperlipidemia (OR 1.62; 95% CI 1.07–2.43), large artery stroke subtype (versus non-large artery stroke, OR 1.79; 95% CI 1.19–2.68), and alcohol drinking habits (OR 1.64; 95% CI 1.06–2.53) were positively associated, while high statin dose (versus low dose, OR 0.6; 95% CI 0.40–0.90) and higher daily number of medication pills (OR 0.93; 95% CI 0.88–0.97) were found to have a negative association with self-reported good adherence to statin medication after acute ischemic stroke. However, stroke severity and diagnosis of hyperlipidemia were not associated with adherence. These results suggest that educational and motivational interventions may enhance statin adherence because modifiable factors were associated with statin adherence.

scholarly journals Women and Stroke: Different, yet Similar

2021 ◽  
pp. 106-111
Author(s):  
Nandini Mitta ◽  
Sapna Erat Sreedharan ◽  
Sankara P. Sarma ◽  
Padmavathy N. Sylaja
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
South India ◽  
Stroke Severity ◽  
Sree Chitra Tirunal Institute ◽  
Large Artery ◽  
Stroke Subtype ◽  
Excellent Outcome ◽  
The Impact

<b><i>Background:</i></b> The impact of gender on acute ischemic stroke, in terms of presentation, severity, etiology, and outcome, is increasingly getting recognized. Here, we analyzed the gender-related differences in etiology and outcome of ischemic stroke in South India. <b><i>Methods:</i></b> Patients with first ever ischemic stroke within 1 week of onset presenting to the Comprehensive Stroke Care Centre, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India, were included in our study. Clinical and risk factor profile was documented. The stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at onset, and stroke subtype classification was done using Trial of Org 10172 in Acute Ischemic Stroke criteria. The 3-month functional outcome was assessed using the modified Rankin Scale (mRS) with excellent outcome defined as an mRS ≤2. <b><i>Results:</i></b> Of the 742 patients, 250 (33.7%) were females. The age, clinical profile, and rate of reperfusion therapies did not differ between the genders. Women suffered more severe strokes (mean NIHSS 9.5 vs. 8.4, <i>p</i> = 0.03). While large artery atherosclerosis was more common in men (21.3% vs. 14.8%, <i>p</i> = 0.03), cardioembolic strokes secondary to rheumatic heart disease were more common in women (27.2% vs. 19.7%, <i>p</i> = 0.02). Men had a better 3-month functional outcome compared to women (68.6% vs. 61.2%, <i>p</i> = 0.04), but was not statistically significant after adjusting for confounders. <b><i>Conclusion:</i></b> Our data, from a single comprehensive stroke unit from South India, suggest that stroke in women are different, yet similar in many ways to men. Guideline-based treatment can result in comparable short-term outcomes, irrespective of admission stroke severity.

scholarly journals Effect of Edaravone on Neurological Symptoms in Real-World Patients With Acute Ischemic Stroke

Stroke ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1805-1811 ◽  
Author(s):  
Susumu Kobayashi ◽  
Shingo Fukuma ◽  
Tatsuyoshi Ikenoue ◽  
Shunichi Fukuhara ◽  
Shotai Kobayashi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Symptoms ◽  
Small Vessel ◽  
Large Artery ◽  
Stroke Subtype ◽  
Vessel Occlusion ◽  
Nihss Score ◽  
Ischemic Stroke Subtype ◽  
History Of

Background and Purpose— In Japan, nearly half of ischemic stroke patients receive edaravone for acute treatment. The purpose of this study was to assess the effect of edaravone on neurological symptoms in patients with ischemic stroke stratified by stroke subtype. Methods— Study subjects were 61 048 patients aged 18 years or older who were hospitalized ≤14 days after onset of an acute ischemic stroke and were registered in the Japan Stroke Data Bank, a hospital-based multicenter stroke registration database, between June 2001 and July 2013. Patients were stratified according to ischemic stroke subtype (large-artery atherosclerosis, cardioembolism, small-vessel occlusion, and cryptogenic/undetermined) and then divided into 2 groups (edaravone-treated and no edaravone). Neurological symptoms were evaluated using the National Institutes of Health Stroke Scale (NIHSS). The primary outcome was changed in neurological symptoms during the hospital stay (ΔNIHSS=NIHSS score at discharge−NIHSS score at admission). Data were analyzed using multivariate linear regression with inverse probability of treatment weighting after adjusting for the following confounding factors: age, gender, and systolic and diastolic blood pressure at the start of treatment, NIHSS score at admission, time from stroke onset to hospital admission, infarct size, comorbidities, concomitant medication, clinical department, history of smoking, alcohol consumption, and history of stroke. Results— After adjusting for potential confounders, the improvement in NIHSS score from admission to discharge was greater in the edaravone-treated group than in the no edaravone group for all ischemic stroke subtypes (mean [95% CI] difference in ΔNIHSS: −0.46 [−0.75 to −0.16] for large-artery atherosclerosis, −0.64 [−1.09 to −0.2] for cardioembolism, and −0.25 [−0.4 to −0.09] for small-vessel occlusion). Conclusions— For any ischemic stroke subtype, edaravone use (compared with no use) was associated with a greater improvement in neurological symptoms, although the difference was small (<1 point NIHSS) and of limited clinical significance.

Neurologic deterioration in patients with acute ischemic stroke or transient ischemic attack

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2178-e2191
Author(s):  
Tai Hwan Park ◽  
Jeong-Kon Lee ◽  
Moo-Seok Park ◽  
Sang-Soon Park ◽  
Keun-Sik Hong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prospective Observational Study ◽  
Stroke Onset ◽  
Large Artery ◽  
Stroke Subtype ◽  
Relative Risks ◽  
Neurologic Deterioration ◽  
Early Arrival ◽  
Ischemic Attack

ObjectiveTo improve epidemiologic knowledge of neurologic deterioration (ND) in patients with acute ischemic stroke (AIS).MethodsIn this prospective observational study, we captured ND prospectively in 29,446 patients with AIS admitted to 15 hospitals in Korea within 7 days of stroke onset. ND was defined as an increase in NIH Stroke Scale (NIHSS) score ≥2 (total), or ≥1 (motor or consciousness), or any new neurologic symptoms. Change in incidence rate after stroke onset, causes, factors associated with ND, modified Rankin Scale (mRS) score at 3 months and 1 year, and a composite of stroke, myocardial infarction, and all-cause death at 1 year were assessed.ResultsND occurred in 4,299 (14.6%) patients. The highest rate, 6.95 per 1,000 person-hours incidence, was within the first 6 hours, which decreased to 2.09 within 24–48 hours, and 0.66 within 72–96 hours after stroke onset. Old age, female sex, diabetes, early arrival, large artery atherosclerosis as a stroke subtype, high NIHSS scores, glucose level, systolic blood pressure, leukocytosis at admission, recanalization therapy, TIA without a relevant lesion, and steno-occlusion of relevant arteries were associated with ND. The causes were stroke progression (71.8%) followed by recurrence (8.5%). Adjusted relative risks (95% CI) for poor outcome (mRS 3–6) at 3 months and 1 year were 1.75 (1.70–1.80) and 1.70 (1.65–1.75), respectively. The adjusted hazard ratio (95% CI) for the composite event was 1.59 (1.45–1.74).ConclusionsND should be taken into consideration as a factor that may influence the outcome in acute ischemic stroke.

scholarly journals Low free triiodothyronineis predicts worsen neurological outcome of patients with acute ischemic stroke: a retrospective study with bioinformatics analysis

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shanchao Zhang ◽  
Xia Zhao ◽  
Shan Xu ◽  
Jing Yuan ◽  
Zhihua Si ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Outcome ◽  
Bioinformatics Analysis ◽  
Nuclear Hormone Receptor ◽  
Signal Pathways ◽  
Stroke Severity ◽  
Large Artery ◽  
Network Analyses ◽  
Ppi Networks

Abstract Backgroud Patients with acute ischemic stroke (AIS) often experience low serum free triiodothyronine (FT3), but the association of low FT3 with stroke severity, subtype and prognosis has not yet been thoroughly studied, and the molecular events underlying these clinical observation were also unclear. Methods We retrospectively collected 221 cases of AIS and 182 non-AIS cases with detailed clinical data from our department. FT3 concentrations were measured on admission to predict functional outcome within 3 months using multivariable models adjusted for other risk factors. Receiver operating characteristic (ROC) curves were calculated to define the best cutoff value of FT3 of stroke severity, subtypes and neurological outcome. Gene set enrichment, pathway mapping and network analyses of deferentially expressed genes (DEGs) were performed. Results FT3 was significantly decreased in AIS patients with National Institutes of Health Stroke Scale (NIHSS) > 3 and 3-months modified Rankin Scale (mRS) > 2. The cut-off value of FT3 for NIHSS on admission was 4.30 pmol/L. Also, FT3 level was significantly lower in large artery atherosclerosis (LAA) group and cardioembolism (CE) group than that in small vessel occlusion (SVO). FT3 value served as an independent predictor for neurological outcomes for which the cut-off value of FT3 was 4.38 pmol/l. Gene ontology (GO) analysis showed that the biological function of DEGs was mainly enriched in multicellur organism, neuron differentiation and cellular response to hypoxia. The cellular components were involved in extracelluar region, exosome and matrix, and the molecular functions were transcriptional activator activity, DNA binding and nuclear hormone receptor binding. Signal pathways analysis was indicative of neuroactive ligand-receptor interaction, thyroid hormone signaling pathway, and protein digestion and absorption these DEGs were involved in. Six related gene were identified as hubs from the protein-protein interaction (PPI) networks. Three modules were selected from PPI, of which MMP4, ADRA2C and EIF3E were recognized as the seed genes. Conclusions Low FT3 value on admission was associated with stroke severity, subtype and prognosis. In addition, DEGs identified from bioinformatics analysis are likely to be candidates for elucidating clinical outcomes with low FT3, and provide us with therapeutic targets for improving stroke prognosis.

Abstract WP215: Patients with Acute Ischemic Stroke Admitted to the Hospital Closest to the Epicenter of 2016 Kumamoto Earthquake

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yoichiro Nagao ◽  
Makoto Nakajima ◽  
Seigo Shindo ◽  
Satoshi Namitome ◽  
Kuniyasu Wada ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Laboratory Data ◽  
Vital Signs ◽  
Stroke Severity ◽  
2016 Kumamoto Earthquake ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Kumamoto Earthquake ◽  
Admission Time

Background: 2016 Kumamoto Earthquake in 2016 is characterized by a huge foreshock of magnitude-6.5, a magnitude-7.3 mainshock, and numerous, sustained aftershocks. Objective: To elucidate the influence of the Kumamoto Earthquake to ischemic stroke by investigating acute stroke patients who were admitted to the acute hospital located closest to the epicenter of the foreshock and mainshock during 1 month. Methods: Acute ischemic stroke patients within 7 days of onset who were admitted during April 14 and May 13, 2016, and those admitted in the same period in 2015 were investigated. Patients’ characteristics, stroke severity, subtype, onset-admission time, and laboratory data were compared between 2015 and 2016. Results: A number of acute ischemic stroke patients increased by 1.2 times from 43 (14 women) to 69 (27 women), and age was younger in 2016 (median, 72 years; interquartile range, 65-81) than in 2015 (78; 67-85; p = 0.042). No differences were observed in background characteristics, vital signs, stroke severity, or stroke subtype between the two years. Onset-to-admission time was longer in 2016 than in 2015 (951 vs. 441 minutes, p = 0.023). Among laboratory data, platelet count was higher after the earthquake, whereas other data were similar in the two years. Conclusions: Number of ischemic stroke admitted to the closest to the epicenter increased than the previous year and the time from onset to admission prolonged. These data indicate that patients were transferred from wider area after huge earthquakes. An increment of platelet was the only change observed in laboratory data after the earthquake. Multicenter, longitudinal observation would be needed to clarify the effect of the earthquake to cerebrovascular events.

scholarly journals Cardioembolic but Not Other Stroke Subtypes Predict Mortality Independent of Stroke Severity at Presentation

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Latha Ganti Stead ◽  
Rachel M. Gilmore ◽  
M. Fernanda Bellolio ◽  
Anunaya Jain ◽  
Alejandro A. Rabinstein ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Small Vessel Disease ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Subtype ◽  
Academic Center ◽  
Ischemic Stroke Subtype ◽  
Study Population ◽  
Toast Criteria

Introduction. Etiology of acute ischemic stroke (AIS) is known to significantly influence management, prognosis, and risk of recurrence.Objective. To determine if ischemic stroke subtype based on TOAST criteria influences mortality.Methods. We conducted an observational study of a consecutive cohort of patients presenting with AIS to a single tertiary academic center.Results. The study population consisted of 500 patients who resided in the local county or the surrounding nine-county area. No patients were lost to followup. Two hundred and sixty one (52.2%) were male, and the mean age at presentation was 73.7 years (standard deviation, SD = 14.3). Subtypes were as follows: large artery atherosclerosis 97 (19.4%), cardioembolic 144 (28.8%), small vessel disease 75 (15%), other causes 19 (3.8%), and unknown 165 (33%). One hundred and sixty patients died: 69 within the first 30 days, 27 within 31–90 days, 29 within 91–365 days, and 35 after 1 year. Low 90-, 180-, and 360-day survival was seen in cardioembolic strokes (67.1%, 65.5%, and 58.2%, resp.), followed for cryptogenic strokes (78.0%, 75.3%, and 71.1%). Interestingly, when looking into the cryptogenic category, those with insufficient information to assign a stroke subtype had the lowest survival estimate (57.7% at 90 days, 56.1% at 180 days, and 51.2% at 1 year).Conclusion. Cardioembolic ischemic stroke subtype determined by TOAST criteria predicts long-term mortality, even after adjusting for age and stroke severity.

scholarly journals Experiences of Thrombolytic Therapy for Ischemic Stroke in Tuzla Canton, Bosnia and Herzegovina

ISRN Stroke ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dževdet Smajlović ◽  
Denisa Salihović ◽  
Omer Ć. Ibrahimagić ◽  
Zikrija Dostović ◽  
Leila Avdić ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Bosnia And Herzegovina ◽  
Developed Countries ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Risk Factor ◽  
Number Of Patients ◽  
The Mean

Aim. To demonstrate our experiences of thrombolytic therapy in acute ischemic stroke. Subjects and Methods. Patients with ischemic stroke treated with rt-PA, admitted at the Department of Neurology, Tuzla, Bosnia and Herzegovina, in the period between April 1, 2008, and December 31, 2012, were included. Results. Between April 2008 and December 2012, intravenous rt-PA was given to 87 patients with acute ischemic stroke, which represents 3.2% of patients with acute ischemic stroke admitted to our department in that period. Hypertension was the leading stroke risk factor. The mean NIHSS score before thrombolysis was 12 (range 4–21). Large artery arteriosclerosis was the most common stroke etiology. The mean door-to-needle time was 72 minutes and onset-to-needle time 152 minutes. Half of patients (44/87) had a significant improvement within the first 24 hours. Parenchymal hemorrhage occurred in 5 patients (6%) and was fatal in two cases. At 3-month follow-up, 45% of patients (39/87) had good outcome (mRS 0 or 1). Sixteen patients were dead at 3 months, and mean baseline stroke severity was significantly higher in patients who died (NIHSS 16.5 versus 11, P=0.003). Conclusion. The number of patients with acute ischemic stroke treated using rt-PA in the Department of Neurology, Tuzla, is lower than in developed countries. Thrombolytic therapy is safe and leads to favorable outcome in half of the patients.

scholarly journals Can Tirofiban Improve the Outcome of Patients With Acute Ischemic Stroke: A Propensity Score Matching Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Lingxin Cai ◽  
Xiaobo Yu ◽  
Jun Yu ◽  
Jing Xu ◽  
Liang Xu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Propensity Score ◽  
Acute Ischemic Stroke ◽  
Propensity Score Matching ◽  
Intracranial Hemorrhage ◽  
Subgroup Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Favorable Outcome ◽  
Large Artery ◽  
Efficacy And Safety

Objective: To evaluate the efficacy and safety of tirofiban for patients with acute ischemic stroke (AIS), especially posterior circulation stroke (PCS).Methods: We enrolled consecutive patients with AIS who suffered large artery occlusion (LAO) and underwent mechanical thrombectomy (MT) between January 2016 and May 2020. Patients were divided into two groups according to whether tirofiban was used during MT. The primary efficacy outcome was a favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0–2 at 3 months. The safety outcomes were the rate of mortality at 3 months and the presence of intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH). Cohorts were balanced using 1:1 propensity score matching (PSM). Subgroup analysis was further performed to compare the efficacy and safety of tirofiban between the anterior circulation stroke (ACS) and PCS groups.Results: A total of 292 patients were eligible for this study and divided into the tirofiban group (n = 51) and the no-tirofiban group (n = 241). In the propensity-score-matched cohort, the tirofiban group had a higher rate of favorable outcomes than the no-tirofiban group (49.0 vs. 25.5%, p = 0.014), and the mortality at 3 months showed a greater downward trend in the tirofiban group than the no-tirofiban group (15.6 vs. 33.3% p = 0.064). The risk of sICH and ICH was the same between the tirofiban and control groups (17.6 vs. 27.4% p = 0.236, 31.3 vs. 45.1% p = 0.154, respectively). Tirofiban use was predictive of favorable outcomes [adjusted odds ratio (aOR) = 2.87, 95% confidence interval (CI) 1.52–6.44, p = 0.043] after multiple logistic regression analysis. Subgroup analysis revealed that tirofiban use was significantly associated with favorable outcomes in ACS (aOR = 3.66, 95% CI 1.24–5.22, p = 0.019) but not in PCS (aOR = 1.12, 95% CI 0.47–7.52, p = 0.570).Conclusion: We demonstrated that tirofiban may be associated with improving favorable outcome for the AIS patients who underwent MT, without increasing ICH or sICH. Furthermore, our results indicated that for PCS patients tirofiban may not be associated with favorable outcome, and more comprehensive randomized controlled trials are needed to confirm this finding.

Embolus Retriever with Interlinked Cages versus other stent retrievers in acute ischemic stroke: an observational comparative study

2018 ◽  
Vol 10 (12) ◽  
pp. e31-e31 ◽  
Author(s):  
Philipp Gruber ◽  
Salome Zeller ◽  
Carlos Garcia-Esperon ◽  
Jatta Berberat ◽  
Javier Anon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Multiple Logistic Regression Analysis ◽  
Case Series ◽  
Favorable Outcome ◽  
Stroke Severity ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Stent Retrievers ◽  
Favorable Clinical Outcome

Background and purposeGiven the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO).MethodsWe reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device. Co-primary outcome was defined as successful recanalization (Thrombolysis in Cerebral Infarction 2b/3) after the first device and favorable outcome (modified Rankin Scale score 0–2) at 90 days' follow-up. Multiple logistic regression analysis was applied to adjust for potential confounders.Results183 consecutive patients with stroke were treated with either ERIC (49%) or a SR (51%) as the first device and successful recanalization was seen in 82% and 57%, respectively (P<0.001). Adding SR to futile ERIC recanalization or vice versa increased final recanalization rates (ERIC: 87%, SR: 79%). The use of ERIC as a first device resulted in favorable clinical outcome in 50% compared with 35% when a SR was used (P=0.038), an effect driven by age, stroke severity, presence of carotid-T-occlusion, and general anesthesia and not by the device deployed.ConclusionThe use of ERIC as a first device appeared to be associated with higher rates of successful recanalization and resulted in better functional outcome. However, favorable outcome was not attributable to ERIC. Most importantly, both device types complemented one another and improved final recanalization rates when used successively.

scholarly journals Association of Prestroke Glycemic Control With Vascular Events During 1-Year Follow-up

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012729
Author(s):  
Jun Young Chang ◽  
Wook-Joo Kim ◽  
Jee Hyun Kwon ◽  
Ji Sung Lee ◽  
Beom Joon Kim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Multivariable Analysis ◽  
Large Artery ◽  
Stroke Subtype ◽  
Vascular Events ◽  
Vascular Death ◽  
Ischemic Stroke Subtype

ObjectiveWe evaluated the association between admission HbA1c and subsequent risk of composite vascular events, including stroke, myocardial infarction, and vascular death, in patients with acute ischemic stroke and diabetes.MethodsPatients who had a transient ischemic attack or an acute ischemic stroke within 7 days of symptom onset, and diabetes were included in a retrospective cohort design using the stroke registry of the Clinical Research Center for Stroke in Korea. The association between admission HbA1c and composite vascular events, including stroke, myocardial infarction (MI), and vascular death, during one-year follow-up was estimated using the Fine-Gray model. The risk of composite vascular events according to the ischemic stroke subtype was explored using fractional polynomial and linear-quadratic models.ResultsOf the 18567 patients, 1437 developed composite vascular events during follow-up. In multivariable analysis using HbA1c as a categorical variable, the risk significantly increased at a threshold of 6.8%–7.0%. The influence of admission HbA1c level on the risk of composite vascular events was pronounced particularly among those in whom fasting glucose at admission was ≤130 mg/dL. The optimal ranges of the HbA1c associated with minimal risks for composite vascular events was the lowest for the small vessel occlusion subtype (6.6, [95% confidence internal [CI], 6.3–6.9]), compared to the large artery atherosclerosis (7.3 [95% CI, 6.8–7.9]) or the cardioembolic subtype (7.4[95% CI, 6.3–8.5]).ConclusionIn patients with ischemic stroke and diabetes, the risks of composite vascular events were significantly associated with admission HbA1c. The optimal range of the admission HbA1c was below 6.8%–7.0%, and were different according to the ischemic stroke subtype.

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