Abstract TP189: Is A Low Ankle-brachial Index A Predictive Factor For Poor Recovery From Acute Ischemic Stroke?

Abstract

Background: The ankle-brachial index (ABI) is widely used as a marker of peripheral arterial disease, and it reflects the severity of systemic atherosclerosis. Lower limb hypoperfusion or ischemia may inhibit recovery from neurological impairment. Whether a low ABI is associated with poor functional outcome after ischemic stroke was examined. Methods: 926 acute ischemic stroke patients (598 males; mean age, 71.1±10.8 years; median age, 72.0 years) who did not undergo t-PA or surgical treatment were enrolled. All provided informed consent and underwent ABI measurement during hospitalization. Baseline characteristics and NIHSS scores at admission were noted, and modified Rankin scale (mRS) scores 3 months after stroke were evaluated. The patients were categorized into normal (≥0.9) and decreased (<0.9) ABI groups, and into fair-outcome (mRS score, 0-2) and poor-outcome (mRS score, 3-6) groups. Results: ABI was decreased in 42 (5.9%) of 713 fair-outcome patients and 31 (14.6%) of 213 poor-outcome patients. The poor-outcome group had a higher average NIHSS score, a higher proportion of patients that were female, underweight, had a stroke history, and aged >75 years, and a lower proportion of patients who had dyslipidemia, a smoking history, and a drinking history. Logistic regression analysis including the above factors showed a relationship with poor outcome. Decreased ABI was negatively related to fair outcome (OR=0.569, 95%CI=0.324-0.999, p=0.050). Comments: Decreased ABI was an independent risk factor correlated with poor outcome 3 months after acute ischemic stroke, suggesting that lower limb and general atherosclerosis may delay or hamper recovery from stroke.