[Detection of silent peripheral arterial disease in stroke patients with a low ankle-arm index].
BACKGROUND
A low ankle-arm index (AAI) is a strong predictor of vascular events and stroke. Nevertheless few studies have prospectively determined AAI in stroke patients. We aimed to investigated the prevalence of low AAI in stroke patients and which variables are associated with abnormal AAI.


METHODS
Clinical data and ultrasonographic findings were collected in 79 consecutive stroke patients (20 transient ischemic attacks and 59 cerebral < ischemic infarction). During admission, AAI was measured in all subjects with the Doppler. An AAI cutoff of 0.90 was used to categorize individuals (< or =0.90: abnormal).


RESULTS
A low AAI was calculated in 16 (20.3%) patients. AAI < or = 0.90 was associated with hypertension, smoking, hypercholesterolemia, coronary disease, previous peripheral arterial disease, male gender, internal carotid stenosis>50% (p<0.10). The presence of peripheral artery disease varied between subtypes. The incidence was higher for large artery atherosclerosis, 25.0 % and small vessel disease (31.5%). Multivariate analyses (logistic regression) only identify the association of>3 risk factors as independent predictor of low AAI (odds ratio: 4.41; confidence interval 95%: 1.39-4.01; p=0.012).


CONCLUSIONS
Stroke patients had higher incidence of low AAI. Abnormal AAI was associated with classical risk factors. Existence of silent peripheral arterial disease in these patients may be an indicator of cerebral atherosclerosis extension. The measurement of AAI may be useful in order to plan adequate prevention therapies.
Purroy
F
F
Servicio de Neurología. Hospital Vall d'Hebron, Barcelona, Spain. 34271fpg@combs.es
Oró
M
M
Quílez
A
A
Sanahuja
J
J
Brieva
L
L
Granés
P
P
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D017585:Ultrasonography, Doppler, Transcranial