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. 2017 Nov 1;24(11):1167-1173.
doi: 10.5551/jat.38901. Epub 2017 May 15.

Ability of the Ankle Brachial Index and Brachial-Ankle Pulse Wave Velocity to Predict the 3-Month Outcome in Patients with Non-Cardioembolic Stroke

Hayato Matsushima  1   2 , Naohisa Hosomi  1 , Naoyuki Hara  1   2 , Takeshi Yoshimoto  1   2 , Shuichiro Neshige  1   2 , Ryuhei Kono  2 , Takahiro Himeno  2 , Shinichi Takeshima  2 , Kazuhiro Takamatsu  2 , Yutaka Shimoe  2 , Taisei Ota  2 , Hirofumi Maruyama  1 , Toshiho Ohtsuki  3 , Masaru Kuriyama  2 , Masayasu Matsumoto  1
Affiliations

Ability of the Ankle Brachial Index and Brachial-Ankle Pulse Wave Velocity to Predict the 3-Month Outcome in Patients with Non-Cardioembolic Stroke

Hayato Matsushima et al. J Atheroscler Thromb. .

Abstract

Aim: Both the ankle brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are surrogates for atherosclerosis. In this study, we aimed to evaluate the ability of ABI and baPWV to predict stroke outcome in patients with first-ever non-cardioembolic stroke.

Methods: This study included consecutive patients with first-ever non-cardioembolic stroke admitted within 1 week after onset to Ota Memorial Hospital between January 2011 and December 2013. Baseline characteristics and National Institutes of Health stroke scale scores at admission were noted. ABI and baPWV were evaluated within 5 days of admission. The patients were categorized according to ABI (cut-off 0.9) and baPWV (cut-off 1870 cm/s) determined using the receiver operation curve for poor outcome. Clinical outcomes were defined based on the modified Rankin scale (mRS) scores 3 months after stroke onset as good (0 and 1) or poor (2-6).

Results: A total of 861 patients were available for evaluation. ABI ＜0.9 and baPWV ＞1870 cm/s were associated with poor outcome in the univariate analysis (p＜0.001 and p＜0.001, respectively). After adjusting for factors that showed differences between groups, ABI ＜0.9 was associated with poor outcome. Among patients with ABI ≥ 0.9, higher baPWV showed a slight association with poor outcome after adjustment [odds ratio 1.46 (95% CI 0.95-2.27)].

Conclusion: Our study suggests that the stroke outcome can be predicted using ABI and to an extent using baPWV when ABI ≥ 0.9 in patients with non-cardioembolic stroke.

Keywords: Ankle brachial index; Brachial-ankle pulse wave velocity; Ischemic stroke; Modified Rankin scale; Non-cardioembolic stroke; Outcome.

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Conflict of interest statement

Dr. Hosomi reports an honorarium from Mochida Pharmaceutical Co., LTD., which is outside the scope of the submitted work. Prof. Matsumoto reports grants from Takeda Pharmaceutical Co., LTD., Sanofi K.K., Mochida Pharmaceutical Co., LTD., Otsuka Pharmaceutical, and Daiichi Sankyo Co., LTD. and honoraria from Sanofi K.K., Bayer Health Care, and Daiichi Sankyo Co., LTD., which are outside the scope of the submitted work. The other authors declare no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Flow chart of inclusion and exclusion criteria
Fig. 2.
Fig. 2.
Scatter plot of ABI and baPWV and their regression lines There are linear associations between these factors, separately for low (< 0.9) and high ABI (≥ 0.9). ABI, ankle brachial index; baPWV, brachial-ankle pulse wave velocity
Fig. 3.
Fig. 3.
Proportion of patients who showed poor outcome (3 month mRS 2–6) and mortality
See this image and copyright information in PMC

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