title: Association between estimated glomerular filtration rate, ankle-brachial index, and recurrent ischemic stroke in a Chinese population of ischemic stroke patients.
abstract: BACKGROUND
  Very few studies have examined combined association of estimated glomerular filtration rate (eGFR) and ankle-brachial index (ABI) on recurrent ischemic stroke in patients with ischemic stroke in Chinese populations.
  
  
  METHODS
  A Chinese population of 1219 ischemic stroke patients was followed up in this six-year prospective study.
  
  
  RESULTS
  1080 ischemic stroke patients with complete follow-up data were included in the statistical analysis. A total of 245 ischemic stroke patients (22.7 %) had recurrent ischemic stroke during follow-up. The Incidence of recurrent ischemic stroke was significantly increased with decreasing eGFR levels and that of patients with eGFR < 30 ml/min/1.73m2 was the highest. Hazard ratio (HR) of eGFR < 30 ml/min/1.73m2 to recurrent ischemic stroke was 2.633 (95 % CI: 1.653 - 4.194) compared with that of eGFR ≥ 60 ml/min/1.73m2 after adjusting for other potential confounders using Cox regression analysis. Incidence of recurrent ischemic stroke was significantly increased with simultaneously decreasing eGFR and ABI. The highest percentage (71.4 %) of patients with eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously had recurrent ischemic stroke during follow-up. HR of eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously with recurrent ischemic stroke was 9.415 (95 % CI: 3.479 - 25.483) compared with that of eGFR ≥ 60 ml/min/1.73m2 and ABI > 1.0 to ≤ 1.4 respectively
  
  
  CONCLUSIONS
  Low ABI and low eGFR together had synergistic effects on increasing recurrent ischemic stroke of ischemic stroke patients during a long-term follow-up.
authors: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors: Yong
authors: Y
authors: Wang
authors: Yong L
authors: YL
authors: Wang
authors: Heng
authors: H
authors: Ma
authors: Jun
authors: J
authors: Yang
authors: Jue
authors: J
authors: Li
authors: Xiaochen
authors: X
authors: Hao
authors: Qingjie
authors: Q
authors: Mou
authors: Jing
authors: J
authors: Liu
authors: Xiaoyan
authors: X
authors: Guo
authors: Dongdong
authors: D
authors: Zhao
authors: Yawei
authors: Y
authors: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D055109:Ankle Brachial Index; D044466:Asian People; D002545:Brain Ischemia / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D013997:Time Factors