Prevalence and Association between Risk Factors, Stroke Subtypes, and Abnormal Ankle Brachial Index in Acute Ischemic Stroke

Ratanakorn, Disya; Keandoungchun, Jesada; Tegeler, Charles H.

doi:10.1016/j.jstrokecerebrovasdis.2010.11.011

Cited by 35 publications

(26 citation statements)

References 21 publications

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“…However, only limited data exists regarding the prevalence of low ABI among ischemic stroke patients in Asian populations. As one recent study from Thailand reported the prevalence of low ABI to be 18.1% in ischemic stroke patients [18], these data suggest Asian populations may have a lower prevalence of low ABI than other Western countries. Another study in a Japanese population also showed a low ABI prevalence of 17% among ischemic stroke patients, though the small sample size of that study precluded the significance of the data [19].…”

Section: Discussionmentioning

confidence: 82%

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Differences of Ankle-Brachial Index according to Ischemic Stroke Subtypes: The Peripheral Artery Disease in Korean Patients with Ischemic Stroke (PIPE) Study

Chung

Kim

et al. 2012

Eur Neurol

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Background/Aims: Although previous studies showed a high prevalence of abnormal ankle-brachial index (ABI) in patients with ischemic stroke, few data exist regarding ABI in Asian patients with ischemic stroke. The purpose of the present study was to determine the prevalence and factors associated with abnormal ABI (≤0.9) in a cohort of ischemic stroke patients. Methods: In this prospective multicenter study, 1,293 patients diagnosed with acute ischemic stroke or transient ischemic attack underwent ABI measurement to evaluate an association between abnormal ABI and vascular risk factors and clinical characteristics. Differences in ABI by stroke subtypes were also assessed. Results: Abnormal ABI of ≤0.9 was found in 13.0%. Patients with abnormal ABI were more likely to be older and had higher initial stroke severity. The prevalence of abnormal ABI was 18.4% in large artery atherosclerosis, 7% in small artery disease, and 19.2% in cardioembolism (p < 0.001). Multiple logistic regression analysis showed that age, hyperlipidemia, diabetes, and large artery atherosclerosis subtype were independent factors associated with abnormal ABI. Conclusions: These data suggest that the prevalence of abnormal ABI in Korean patients with ischemic stroke was lower than that in Caucasian patients, which might be associated with ethnic differences in underlying stroke subtypes.

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Section: Discussionmentioning

confidence: 82%

“…A recent study conducted on Asian ethnicity also showed a higher prevalence of abnormal ABI in patients with LAA (20.4%) than in those with SAD (12.7%) [18]. However, the Austrian OECROSS Study showed a rather similar prevalence of abnormal ABI in patients with both LAA (51.9%) and SAD (48%) [14].…”

Section: Discussionmentioning

confidence: 99%

Differences of Ankle-Brachial Index according to Ischemic Stroke Subtypes: The Peripheral Artery Disease in Korean Patients with Ischemic Stroke (PIPE) Study

Chung

Kim

et al. 2012

Eur Neurol

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“…In Thailand, several studies have addressed stroke prevalence, risk factors, management, and outcomes [10][11][12]. The mean age of stroke patients in Thailand is approximately 65 years and there is a slight male predominance (57%).…”

Section: Introductionmentioning

confidence: 99%

“…Hypertension was the most common risk factor, seen in 57% of patients, followed by smoking (29%) and diabetes (24%). Eighteen percent of acute ischemic stroke patients also had an abnormal ankle brachial index suggestive of comorbid peripheral artery disease [10]. Information regarding predictors for in-hospital mortality and the impact of serious medical and neurological complications, however, is limited [13].…”

Section: Introductionmentioning

confidence: 99%

National data on stroke outcomes in Thailand

Kongbunkiat

Kasemsap

Thepsuthammarat

et al. 2015

Journal of Clinical Neuroscience

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“…However, because pathogenesis seems similar between the 2 diseases, the phenotypic expression might be entirely different making it difficult, if not impossible, to select stroke patients for ABI screening solely based on vascular comorbidities. 3,4 Conversely, a one-size-fits-all approach by screening all acute stroke patients is barely feasible in most stroke centers worldwide nor is it supported by current stroke guidelines. 24 …”

Section: Discussionmentioning

confidence: 99%

Increased Pulsatility of the Intracranial Blood Flow Spectral Waveform on Transcranial Doppler Does Not Point to Peripheral Arterial Disease in Stroke Patients

Barlinn

Kolieskova

Shahripour

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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Background Peripheral arterial disease (PAD) is common in patients with acute cerebral ischemia. Indexes of resistance derived from the systolic and diastolic velocities are routinely used in diagnostic transcranial Doppler (TCD) to detect intracranial arterial disease. We sought to explore whether these indexes can predict the presence of PAD in acute cerebral ischemia. Methods We prospectively evaluated consecutive patients with acute cerebral ischemia. On TCD, peak-systolic and end-diastolic velocities in both middle cerebral and basilar arteries were manually measured to calculate pulsatility index (PI) and resistance index (RI). Increased resistance was defined as PI equal to 1.2 or more and RI equal to .75 or more. Ankle–brachial index (ABI) measurements were performed and an ABI equal to .9 or more was considered predictive of definite PAD. Results We included 95 patients (45 male, 50 female) aged 66 ± 9 years with a median National Institutes Health Stroke Scale score of 3 (interquartile range, 8) points. The ABI was abnormal and consistent with definite PAD in 24 of 95 (25.3%; 95% confidence interval [CI], 16.4–34.2) patients. Increased PI did not differ among patients with and without PAD (20.8% vs. 28.2%, P = .60). Only 1 patient with PAD had increased RI as opposed to 4 patients without PAD (4.2% vs. 5.6%, P = 1.0). Increased PI was not found to be an independent predictor of PAD (odds ratio [OR], .68; 95% CI, .22–2.12; P = .51). Increases in both PI and RI independently predicted arterial hypertension (OR, 1.62; 95% CI, 1.19–2.21; P = .002 and OR, 3.20; 95% CI, 1.51–6.77; P = .002, respectively). Conclusions Our findings indicate that PAD cannot be inferred from intracranial flow parameters predictive of arterial disease and risk factors such as hypertension among patients with acute cerebral ischemia.

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Prevalence and Association between Risk Factors, Stroke Subtypes, and Abnormal Ankle Brachial Index in Acute Ischemic Stroke

Cited by 35 publications

References 21 publications

Differences of Ankle-Brachial Index according to Ischemic Stroke Subtypes: The Peripheral Artery Disease in Korean Patients with Ischemic Stroke (PIPE) Study

Differences of Ankle-Brachial Index according to Ischemic Stroke Subtypes: The Peripheral Artery Disease in Korean Patients with Ischemic Stroke (PIPE) Study

National data on stroke outcomes in Thailand

Increased Pulsatility of the Intracranial Blood Flow Spectral Waveform on Transcranial Doppler Does Not Point to Peripheral Arterial Disease in Stroke Patients

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