Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.
Department of Neurology, Brain Attack Center Ota Memorial Hospital.
J Atheroscler Thromb. 2017 Nov 1;24(11):1167-1173. doi: 10.5551/jat.38901. Epub 2017 May 15.
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.
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).
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)].
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.
踝臂指数（ABI）和臂踝脉搏波速度（baPWV）均为动脉粥样硬化的替代指标。本研究旨在评估 ABI 和 baPWV 预测首发非心源性脑卒患者卒中结局的能力。
该研究纳入了 2011 年 1 月至 2013 年 12 月期间在大分纪念医院发病后 1 周内连续入院的首发非心源性脑卒患者。记录了基线特征和入院时的国立卫生研究院卒中量表评分。入院后 5 天内评估 ABI 和 baPWV。根据 ABI（截断值 0.9）和 baPWV（截断值 1870 cm/s）的受试者工作特征曲线确定的患者进行分类，用于预测不良结局。根据卒中发病后 3 个月的改良 Rankin 量表（mRS）评分，将临床结局定义为良好（0 和 1）或不良（2-6）。
共有 861 例患者可用于评估。单因素分析显示，ABI＜0.9 和 baPWV＞1870 cm/s 与不良结局相关（p＜0.001 和 p＜0.001）。在校正组间差异有统计学意义的因素后，ABI＜0.9 与不良结局相关。在 ABI≥0.9 的患者中，校正后 baPWV 较高与不良结局有轻微关联[比值比 1.46（95%CI 0.95-2.27）]。
本研究表明，在非心源性脑卒患者中，ABI 可预测卒中结局，在 ABI≥0.9 时，baPWV 可在一定程度上预测卒中结局。
