Predicting stroke outcomes using Ankle-Brachial index and inter-ankle blood pressure difference

Minho Han, Young Dae Kim, Jin Kyo Choi, Junghye Choi, Jimin Ha, Eunjeong Park, Jinkwon Kim, Tae Jin Song, Ji Hoe Heo, Hyo Suk Nam

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: This study investigated the association of high ankle-brachial index difference (ABID) and systolic inter-ankle blood pressure difference (IAND) with short-and long-term outcomes in acute ischemic stroke patients without peripheral artery disease (PAD). Methods: Consecutive patients with acute ischemic stroke who underwent ankle-brachial index (ABI) measurement were enrolled. ABID was calculated as |right ABI-left ABI|. IAND and systolic inter-arm blood pressure difference (IAD) were calculated as |right systolic blood pressure – left systolic blood pressure|. Poor functional outcome was defined as modified Rankin Scale score ≥3 at 3 months. Major adverse cardiovascular events (MACEs) were defined as stroke recurrence, myocardial infarction, or death. Results: A total of 2901 patients were enrolled and followed up for a median of 3.1 (interquartile range, 1.6–4.7) years. Among them, 2643 (84.9%) patients did not have PAD. In the logistic regression analysis, ABID ≥ 0.15 and IAND ≥ 15 mmHg were independently associated with poor functional outcome (odds ratio (OR), 1.970, 95% confidence interval (CI), 1.175-3.302; OR, 1.665, 95% CI, 1.188-2.334, respectively). In Cox regression analysis, ABID ≥0.15 and IAND ≥ 15 mmHg were independently associated with MACEs (hazard ratio (HR), 1.514, 95% CI, 1.058-2.166; HR, 1.343, 95% CI, 1.051-1.716, respectively) and all-cause mortality (HR, 1.524, 95% CI, 1.039-2.235; HR, 1.516, 95% CI, 1.164-1.973, respectively) in patients without PAD. Conclusion: High ABID and IAND are associated with poor short-term outcomes, long-term MACE occurrence, and all-cause mortality in acute ischemic stroke without PAD.

Original languageEnglish
Article number1125
JournalJournal of Clinical Medicine
Volume9
Issue number4
DOIs
StatePublished - Apr 2020

Keywords

  • Ankle-brachial index difference
  • Inter-ankle blood pressure difference
  • Outcome
  • Peripheral artery disease
  • Stroke

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