Ankle‐brachial index long‐term outcome after first‐ever ischaemic stroke. Issue Volume 20:Issue11(2013:Nov.) (7th June 2013)

• Record Type: Journal Article
• Authors: Milionis, H.; Vemmou, A.; Ntaios, G.; Makaritsis, K.; Koroboki, E.; Papavasileiou, V.; Savvari, P.; Spengos, K.; Elisaf, M.; Vemmos, K.
• Is Part Of: European journal of neurology. Volume 20:Issue11(2013:Nov.)
• Page Start: 1471
• Page End: 1478
• Publication Date: 2013-06-07
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.12208
• Languages: English
• ISSNs: 1351-5101

Abstract

<abstract abstract-type="main" id="ene12208-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ene12208-sec-0001" sec-type="section"> <title>Background and purpose</title> <p>Ankle‐brachial blood pressure index (ABI) is a clinical tool to identify the presence of peripheral artery disease. There is a scarcity of data associating ABI with long‐term outcome in patients with IS. The association between ABI and long‐term outcome in patients with first‐ever acute IS was assessed.</p> </sec> <sec id="ene12208-sec-0002" sec-type="section"> <title>Methods</title> <p>Ankle‐brachial blood pressure index was assessed in all consecutive patients with a first‐ever acute IS admitted at Alexandra University hospital (Athens, Greece) between January 2005 and December 2010. ABI was considered normal when > 0.90 and ≤ 1.30. The Kaplan–Meier product limit method was used to estimate the probability of 5‐year composite cardiovascular event‐free (defined as recurrent stroke, myocardial infarction or cardiovascular death) and overall survival. A multivariate analysis was performed to assess whether ABI is an independent predictor of 5‐year mortality and dependence.</p> </sec> <sec id="ene12208-sec-0003" sec-type="section"> <title>Results</title> <p>Amongst 653 patients, 129 (19.8%) with ABI ≤ 0.9 were identified. Five‐year cumulative composite cardiovascular event‐free and overall survival rates were better in normal ABI stroke patients (log‐rank test: 7.22, <italic>P</italic> = 0.007 and 23.40, <italic>P</italic> < 0.001, respectively). There was no difference in 5‐year risk of stroke recurrence between low and normal ABI groups (hazard ratio, HR = 1.23, 95%CI 0.68–2.23). In multivariate Cox regression analysis, independent predictors of 5‐year mortality included age (HR = 2.55 per 10 years, 95%CI 1.86–3.48, <italic>P</italic> < 0.001), the National Institutes of Health Stroke Scale (per point increase HR = 1.12, 95%CI 1.08–1.16, <italic>P</italic> < 0.001), and low ABI (HR = 2.22, 95%CI 1.22–4.03, <italic>P</italic> = 0.009). Age (HR = 1.21 per 10 years, 95%CI 1.01–1.45, <italic>P</italic> = 0.04) and low ABI (HR = 1.72, 95%CI 1.11–2.67, <italic>P</italic> = 0.01) were independent predictors of the composite cardiovascular end‐point.</p> </sec> <sec id="ene12208-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Low ABI in patients with acute IS is associated with increased 5‐year cardiovascular event risk and mortality. However, ABI does not appear to predict long‐term stroke recurrence.</p> </sec> </abstract>