Han Minho, Kim Young Dae, Choi Jin Kyo, Choi Junghye, Ha Jimin, Park Eunjeong, Kim Jinkwon, Song Tae-Jin, Heo Ji Hoe, Nam Hyo Suk
Department of Neurology, Yonsei University College of Medicine, Seoul 03722, Korea.
Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Seoul 03722, Korea.
J Clin Med. 2020 Apr 15;9(4):1125. doi: 10.3390/jcm9041125.
This study investigated the association of high ankle-brachial index difference (ABID) and systolic inter-ankle blood pressure difference (IAND) with short- and long-term outcomes in acute ischemic stroke patients without peripheral artery disease (PAD).
Consecutive patients with acute ischemic stroke who underwent ankle-brachial index (ABI) measurement were enrolled. ABID was calculated as |right ABI-left ABI|. IAND and systolic inter-arm blood pressure difference (IAD) were calculated as |right systolic blood pressure - left systolic blood pressure|. Poor functional outcome was defined as modified Rankin Scale score ≥3 at 3 months. Major adverse cardiovascular events (MACEs) were defined as stroke recurrence, myocardial infarction, or death.
A total of 2901 patients were enrolled and followed up for a median of 3.1 (interquartile range, 1.6-4.7) years. Among them, 2643 (84.9%) patients did not have PAD. In the logistic regression analysis, ABID ≥ 0.15 and IAND ≥ 15 mmHg were independently associated with poor functional outcome (odds ratio (OR), 1.970, 95% confidence interval (CI), 1.175‒3.302; OR, 1.665, 95% CI, 1.188‒2.334, respectively). In Cox regression analysis, ABID ≥0.15 and IAND ≥ 15 mmHg were independently associated with MACEs (hazard ratio (HR), 1.514, 95% CI, 1.058‒2.166; HR, 1.343, 95% CI, 1.051‒1.716, respectively) and all-cause mortality (HR, 1.524, 95% CI, 1.039‒2.235; HR, 1.516, 95% CI, 1.164‒1.973, respectively) in patients without PAD.
High ABID and IAND are associated with poor short-term outcomes, long-term MACE occurrence, and all-cause mortality in acute ischemic stroke without PAD.
本研究调查了在无外周动脉疾病（PAD）的急性缺血性卒中患者中，高踝臂指数差值（ABID）和收缩期踝间血压差值（IAND）与短期和长期预后的相关性。
纳入连续接受踝臂指数（ABI）测量的急性缺血性卒中患者。ABID计算为|右侧ABI - 左侧ABI|。IAND和收缩期臂间血压差值（IAD）计算为|右侧收缩压 - 左侧收缩压|。功能预后不良定义为3个月时改良Rankin量表评分≥3分。主要不良心血管事件（MACE）定义为卒中复发、心肌梗死或死亡。
共纳入2901例患者，中位随访3.1（四分位间距，1.6 - 4.7）年。其中，2643例（84.9%）患者无PAD。在逻辑回归分析中，ABID≥0.15和IAND≥15 mmHg与功能预后不良独立相关（优势比（OR）分别为1.970，95%置信区间（CI）为1.175 - 3.302；OR为1.665，95% CI为1.188 - 2.334）。在Cox回归分析中，ABID≥0.15和IAND≥15 mmHg与无PAD患者的MACE（风险比（HR）分别为1.514，95% CI为1.058 - 2.166；HR为1.343，95% CI为1.051 - 1.716）和全因死亡率（HR分别为1.524，95% CI为1.039 - 2.235；HR为1.516，95% CI为1.164 - 1.973）独立相关。
在无PAD的急性缺血性卒中患者中，高ABID和IAND与短期预后不良、长期MACE发生及全因死亡率相关。
