Abstract P679: Ankle-Brachial Index is Independently Associated With Functional Outcome After Stroke

Abstract

Introduction: The ankle-brachial index (ABI) is the ratio between systolic blood pressure of the upper and lower limbs. A low ABI ( < 0.9) is associated with increased risk of cardiovascular and stroke outcomes. However, ABI relevance for functional outcomes is unknown. Objective: We aimed to investigate if low ABI is associated with functional outcome in stroke patients. Methods: Consecutive patients with imaging-confirmed ischemic stroke were recruited from a public hospital in Salvador, Brazil. Demographic and cerebrovascular risk factor data were collected prospectively. We used NIH stroke scale to quantify stroke severity and ABI was measured on admission. Patients were followed for 90 days and functional outcome was assessed by modified Rankin Scale (mRS). Poor outcome was defined as a mRS = 3 to 6. Logistic regression was used to adjust for potential confounders of poor outcome. Results: We recruited 376 patients with ischemic stroke between October 2018 and October 2019, mean age 64 +/- 13 years, 189 (49%) female. Median ABI was 1.06 (interquartile range - IQR 0.93 to 1.13). After 90 days, 209 (56%) patients had poor outcome. Low ABI was more frequent in patients with poor outcome (38% vs 18%, p=0.0001). After adjustment for age, sex and cerebrovascular risk factors, low ABI remained a significant predictor of poor outcome (odds ratio 2.10; 95% confidence interval 1.24 - 3.55, p=0.006). Conclusions: Low ABI is an independent predictor of poor outcome in acute stroke patients. Assessment of ABI on admission is clinically useful as a prognostic tool and should be more routinely implemented.