Additional file 2: of Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients

Table S1. Interaction between glycemic parameters for functional outcome (modified Rankin’s scale) at discharge. Table S2. Interaction between glycemic parameters and stroke subtypes for initial stroke severity. (DOCX 25 kb

Additional file 3: of Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients

Figure S2. Correlation plot between HbA1c and fasting blood sugar. (TIF 72 kb

Additional file 1: of Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients

Figure S1. Eligibility criteria of the study subjects. (TIF 86 kb

Cardiac Function and Outcome in Patients with Cardio-Embolic Stroke

<div><p>Background</p><p>The relationship between whole spectrum of Ejection fraction (EF) and cardioembolic stroke (CES) outcome has not been fully described yet. Notably, it remains unclear whether borderline EF (41∼49%) is related with poor outcome after CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict the outcome in patients with CES.</p><p>Method and Results</p><p>We evaluated the relationship between EF and functional outcome in 437 consecutive patients with CES. EF was introduced as continuous and categorical (EF≤40%, EF 41∼49%, EF≥50%) variable. Patients with CES and the subgroup with AF were evaluated separately. Poor short-term outcome (modified Rankin Score≥3at discharge or death within 90 days after stroke onset) and long-term mortality were evaluated. A total of 165 patients (37.8%) had poor short-term outcomes. EF tends to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Reduced EF (EF≤40%) showed higher mortality (HR 2.61), and those with borderline EF (41∼49%) had a tendency of higher mortality (HR 1.65, p-value 0.067)compared with those with normal EF.</p><p>Conclusion</p><p>We found a strong association between lower EF and CES outcome. Echocardiographic evaluation helps to better determine the prognosis in CES patients, even in subgroup of patients with AF.</p></div

Basic demographics.

<p>Values are mean±SD or number of patients (percentage).</p><p>AF: Atrial fibrillation, NIHSS: National Institutes of Health Stroke Scale, IV: Intravenous, IA: Intraarterial,</p

EF according to short-term functional outcome (A), 90 days mortality (B), and mRS in CES patients (C).

<p>ns: not significant, ***: p-value <0.01. Abbreviations: ns: not significant, EF, Ejection fraction.mRS: modified Rankin Scale, CES: Cardioembolic stroke.</p

Distribution of EF in included CES patients.

<p>Abbreviations: EF:Ejection fraction, CES: Cardioembolic stroke.</p

Kaplan-Meier curves of long-term mortality by EF groups in CES patients (A) and AF subgroup (B).

<p>Abbreviations: EF, Ejection fraction. CES: Cardioembolic stroke, AF: Atrial fibrillation.</p

Multivariable model hazard ratios for long-term outcomes by EF compared with normal values.

<p>Adjusted for age, sex, history of stroke, hypertension, diabetes, dyslipidemia, smoking,</p><p>Admission NIHSS (<7, 7–14, >14), IV or IA thrombolysis,discharge warfarin, hemorrhagic transformation.</p><p>EF: Ejection Fraction, CES: cardioembolic stroke, AF: Atrial fibrillation, NIHSS: National Institutes of Health Stroke Scale,</p><p>IV: Intra-venous, IA: Intra-arterial.</p

Flow chart of patient enrollment.

<p>Abbreviations: SNUHSR: Seoul National University Hospital Stroke Registry, CES: Cardio-embolic stroke, TIA: Transient ischemic attack, EF: Ejection Fraction.</p