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High prevalence of peripheral arterial disease in patients with acute ischaemic stroke.
Cerebrovasc Dis. 2010 Feb; 29(3):248-54.CD

Abstract

BACKGROUND

After acute ischaemic stroke (AIS) or transient ischaemic attack (TIA), the detection of peripheral arterial disease (PAD) as a marker of generalized atherosclerosis may improve the risk stratification and prevention of future atherothrombotic events. We aimed to determine the prevalence of PAD indicated by an ankle-brachial index (ABI) of < or =0.9 in a large cohort of patients with AIS/TIA.

METHODS

In this prospective, multicentre, Austrian, cross-sectional study (OECROSS), 759 patients with AIS or TIA were recruited for a systematic assessment of cardiovascular risk profiles and Doppler ultrasound at the ankle and brachial artery to calculate the ABI from systolic blood pressure readings.

RESULTS

739 patients (97.4%) had a complete ABI assessment. The mean age was 69.5 (+/- 12.1) years, and 55.8% of the patients were men. 81.6% of the patients had AIS and 18.4% had TIA. Only 6.2% of the patients had a history of PAD, but an abnormal ABI of < or =0.9 was found in 44.9%. Patients with an ABI of < or =0.9 were more likely (p < 0.05) to be older and have a history of PAD, hypertension, diabetes and congestive heart failure. An ABI of < or =0.9 was significantly associated (p < 0.0005) with a presence of carotid stenosis of >50% and an Essen Stroke Risk Score of >2, indicating a risk of > or =4% per year of stroke recurrence.

DISCUSSION

A high proportion of patients with AIS/TIA have subclinical PAD, a cross-risk stroke physicians should be aware of. Large longitudinal studies are needed to elucidate whether the ABI can improve our estimation of the risk of future atherothrombotic events and help in optimizing secondary prevention.

Authors+Show Affiliations

Department of Neurology, Academic Teaching Hospital Wagner-Jauregg, Linz, Austria. raffi.topakian@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

20029198

Citation

Topakian, Raffi, et al. "High Prevalence of Peripheral Arterial Disease in Patients With Acute Ischaemic Stroke." Cerebrovascular Diseases (Basel, Switzerland), vol. 29, no. 3, 2010, pp. 248-54.
Topakian R, Nanz S, Rohrbacher B, et al. High prevalence of peripheral arterial disease in patients with acute ischaemic stroke. Cerebrovasc Dis. 2010;29(3):248-54.
Topakian, R., Nanz, S., Rohrbacher, B., Koppensteiner, R., & Aichner, F. T. (2010). High prevalence of peripheral arterial disease in patients with acute ischaemic stroke. Cerebrovascular Diseases (Basel, Switzerland), 29(3), 248-54. https://doi.org/10.1159/000267850
Topakian R, et al. High Prevalence of Peripheral Arterial Disease in Patients With Acute Ischaemic Stroke. Cerebrovasc Dis. 2010;29(3):248-54. PubMed PMID: 20029198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of peripheral arterial disease in patients with acute ischaemic stroke. AU - Topakian,Raffi, AU - Nanz,Sylvia, AU - Rohrbacher,Bernhard, AU - Koppensteiner,Renate, AU - Aichner,Franz T, AU - ,, Y1 - 2009/12/18/ PY - 2009/05/25/received PY - 2009/10/14/accepted PY - 2009/12/24/entrez PY - 2009/12/24/pubmed PY - 2010/3/5/medline SP - 248 EP - 54 JF - Cerebrovascular diseases (Basel, Switzerland) JO - Cerebrovasc Dis VL - 29 IS - 3 N2 - BACKGROUND: After acute ischaemic stroke (AIS) or transient ischaemic attack (TIA), the detection of peripheral arterial disease (PAD) as a marker of generalized atherosclerosis may improve the risk stratification and prevention of future atherothrombotic events. We aimed to determine the prevalence of PAD indicated by an ankle-brachial index (ABI) of < or =0.9 in a large cohort of patients with AIS/TIA. METHODS: In this prospective, multicentre, Austrian, cross-sectional study (OECROSS), 759 patients with AIS or TIA were recruited for a systematic assessment of cardiovascular risk profiles and Doppler ultrasound at the ankle and brachial artery to calculate the ABI from systolic blood pressure readings. RESULTS: 739 patients (97.4%) had a complete ABI assessment. The mean age was 69.5 (+/- 12.1) years, and 55.8% of the patients were men. 81.6% of the patients had AIS and 18.4% had TIA. Only 6.2% of the patients had a history of PAD, but an abnormal ABI of < or =0.9 was found in 44.9%. Patients with an ABI of < or =0.9 were more likely (p < 0.05) to be older and have a history of PAD, hypertension, diabetes and congestive heart failure. An ABI of < or =0.9 was significantly associated (p < 0.0005) with a presence of carotid stenosis of >50% and an Essen Stroke Risk Score of >2, indicating a risk of > or =4% per year of stroke recurrence. DISCUSSION: A high proportion of patients with AIS/TIA have subclinical PAD, a cross-risk stroke physicians should be aware of. Large longitudinal studies are needed to elucidate whether the ABI can improve our estimation of the risk of future atherothrombotic events and help in optimizing secondary prevention. SN - 1421-9786 UR - https://www.unboundmedicine.com/medline/citation/20029198/High_prevalence_of_peripheral_arterial_disease_in_patients_with_acute_ischaemic_stroke_ L2 - https://www.karger.com?DOI=10.1159/000267850 DB - PRIME DP - Unbound Medicine ER -