Department of Nephrology, Tainan Sin-Lau Hospital, Tainan, Taiwan.
Department of Cardiology, Tainan Sin-Lau Hospital, Tainan, Taiwan.
Vascular. 2021 Feb;29(1):119-125. doi: 10.1177/1708538120925954. Epub 2020 Jul 1.
The ankle-brachial index is a noninvasive modality to evaluate atherosclerosis and is a predictive role for future cardiovascular events and mortality. However, few studies have evaluated its relation to long-term future ischemic stroke in hemodialysis patients. Therefore, we examined the relationship between ankle-brachial index and ischemic stroke events among hemodialysis patients in a seven-year follow-up.
A total of 84 patients were enrolled. Ankle-brachial index was assessed in January 2009. Primary outcomes included ischemic stroke. An ankle-brachial index < 0.9 was considered abnormal and 1.4 ≥ ankle-brachial index ≥ 0.9 to be normal ankle-brachial index.
Mean values for ankle-brachial index were 0.98 ± 0.21at study entrance. In addition, 28 patients encountered ischemic stroke in the seven-year follow-up. In univariate Cox regression analysis, old age (hazard ratio (HR): 1.065, 95% confidence interval (CI): 1.030-1.102, < 0.001), low seven-year averaged serum phosphate levels (HR: 0.473, 95% CI: 0.306-0.730, = 0.001), and abnormal ankle-brachial index (HR: 0.035, 95% CI: 0.009-0.145, < 0.001) were risk factors for ischemic stroke. In multivariate Cox regression analysis for significant variables in univariate analysis, abnormal ankle-brachial index (HR: 0.058, 95% CI: 0.012-0.279, < 0.001) and low seven-year averaged serum phosphate levels (HR: 0.625, 95% CI: 0.404-0.968, = 0.035) remained the risk factors for ischemic stroke. The risk of ischemic stroke was 3.783-fold in patients with abnormal ankle-brachial index compared with patients with normal ankle-brachial index (HR: 3.783, 95% CI: 1.731-8.269, = 0.001).
These findings suggest that ankle-brachial index is an impressive predictor of future ischemic stroke among hemodialysis patients.
踝肱指数是一种评估动脉粥样硬化的非侵入性方法，对未来心血管事件和死亡率具有预测作用。然而，很少有研究评估其与血液透析患者长期未来缺血性卒中的关系。因此，我们在 7 年的随访中检查了踝肱指数与血液透析患者缺血性卒中事件之间的关系。
共纳入 84 例患者。2009 年 1 月评估踝肱指数。主要结局包括缺血性卒中。踝肱指数<0.9 被认为异常，1.4≥踝肱指数≥0.9 为正常踝肱指数。
研究入组时踝肱指数的平均值为 0.98±0.21。此外，在 7 年的随访中，有 28 例患者发生缺血性卒中。在单变量 Cox 回归分析中，高龄（风险比（HR）：1.065，95%置信区间（CI）：1.030-1.102， < 0.001）、7 年平均血清磷酸盐水平较低（HR：0.473，95%CI：0.306-0.730， = 0.001）和异常踝肱指数（HR：0.035，95%CI：0.009-0.145， < 0.001）是缺血性卒中的危险因素。在单变量分析中具有显著意义的变量的多变量 Cox 回归分析中，异常踝肱指数（HR：0.058，95%CI：0.012-0.279， < 0.001）和 7 年平均血清磷酸盐水平较低（HR：0.625，95%CI：0.404-0.968， = 0.035）仍然是缺血性卒中的危险因素。与踝肱指数正常的患者相比，踝肱指数异常的患者发生缺血性卒中的风险高 3.783 倍（HR：3.783，95%CI：1.731-8.269， = 0.001）。
这些发现表明，踝肱指数是血液透析患者未来发生缺血性卒中的一个有意义的预测指标。
