Ankle-brachial index and neurologic deterioration in acute ischemic stroke.

Abstract

BACKGROUND:

Few studies have examined the relationship between abnormal ankle-brachial index (ABI) and short-term outcome in patients with acute ischemic stroke (AIS).

METHODS:

We included 209 consecutive patients with AIS admitted to our hospital and divided them into abnormal ABI (≤.9) and normal ABI (>.9) groups. We defined neurologic deterioration (ND) as an increase of 1 or more points in the National Institutes of Health Stroke Scale score within 7 days of stroke onset. Clinical characteristics were compared between the 2 groups. Then, we performed a multiple logistic regression analysis to identify independent predictors of ND. In the multivariate analysis, the ABI values were used separately as binary variables in different cutoff thresholds (.9, 1.0, and 1.1).

RESULTS:

Of the 209 patients, 24 (11.5%) had an abnormal ABI. The patients in abnormal and normal ABI groups showed significant differences in carotid arterial stenosis (37.5% versus 18.9%; P = .040), intracranial artery stenosis (54.2% versus 18.9%; P < .001), and previous use of antiplatelet drugs (58.3% versus 29.2%; P = .004). According to the multivariate analysis, ABIs of .9 or less and 1.0 or less were positively associated with ND (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.03-2.89; P = .034 and OR, 1.63; 95% CI, 1.05-2.54; P = .027, respectively), whereas an ABI value of 1.1 or less was not an independent predictor of ND (OR, 1.17; 95% CI, 0.79-1.74; P = .43).

CONCLUSIONS:

Not only an ABI of .9 or less but also an ABI of 1.0 or less can be a predictor of ND in patients with AIS.

• Authors: Kentaro Ishizuka, Takao Hoshino, Shinichiro Uchiyama
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) 2014 Nov-Dec Vol. 23 Issue 10 Pg. 2506-2510 ISSN: 1532-8511 [Electronic] United States
• PMID: 25282189 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Platelet Aggregation Inhibitors

Topics

• Aged
• Aged, 80 and over
• Ankle Brachial Index (statistics & numerical data)
• Brain Ischemia (physiopathology)
• Carotid Stenosis (drug therapy, physiopathology)
• Female
• Humans
• Intracranial Arterial Diseases (drug therapy, physiopathology)
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Platelet Aggregation Inhibitors (administration & dosage)
• Predictive Value of Tests
• Prognosis
• Risk Factors
• Stroke (physiopathology)