The prognostic role of ankle brachial index in patients with acute ischemic stroke

Konstantinos Tziomalos, Vasilios Giampatzis, Stella D. Bouziana, Athinodoros Pavlidis, Marianna Spanou, Giannis Kagelidis, Chrysoula Boutari, Christos Savopoulos, Apostolos I. Hatzitolios



Introduction: Peripheral arterial disease (PAD) is frequently present in patients with acute ischemic stroke (IS). However, there are limited data regarding the association between ankle brachial index (ABI)≤0.90 (which is diagnostic of PAD) or >1.40 (suggesting calcified arteries) and IS severity and outcome. Material-methods: We prospectively studied 342 consecutive patients admitted for IS. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS) at admission. The outcome was assessed with the modified Rankin scale (mRS) at discharge and in-hospital mortality. Results: An ABI≤0.90 was present in 24.6% of the patients whereas 68.1% had ABI 0.91-1.40 and 7.3% had ABI>1.40. At admission, the NIHSS score did not differ between the 3 groups (10.4±10.6, 8.3±9.3 and 9.3±9.4, respectively). At discharge, the mRS score did not differ between the 3 groups (2.9±2.2, 2.3±2.1 and 2.7±2.5, respectively). In-hospital mortality was almost two-times higher in patients with ABI≤0.90 than in patients with ABI 0.91-1.40 or >1.40 but this difference was not significant (10.9, 6.6 and 6.3%, respectively). Conclusions: An ABI≤0.90 or >1.40 does not appear to be associated with stroke severity or short-term outcome.

Keywords: ankle brachial index, peripheral arterial disease, stroke, type 2 diabetes mellitus, smoking, outcome, non-compressible arteries