title: Predictive value of ankle-brachial index and PAI-1 in symptomatic intracranial atherosclerotic disease recurrence.
abstract: OBJECTIVE
  We prospectively examine the single and combined predictive value of biological and clinical markers in recurrent strokes related to intracranial atherosclerotic disease (ICAD).
  
  
  METHODS
  In 73 ICAD first-ever stroke patients, ankle-brachial index (ABI) was assessed three months after TIA or stroke together with CRP, Lp-PLA2, ICAM-1, E-selectin and PAI-1 measurements. Appearance of new TIA/stroke was assessed every 6 months.
  
  
  RESULTS
  After a median follow-up of 22.4 months, 13 patients (17.8%) suffered a new stroke or TIA. Risk of new cerebrovascular events (CVEs) was associated with lowered ABI (p=0.011), baseline PAI-1>22.52 ng/ml (<0.001), E-selectin>24.75 ng/ml (p = 0.008) and ICAM-1>205 ng/ml (p = 0.029). The combination of PAI-1 with ABI or ESRS reclassified 55.4% (p<0.005) and 48.3% (p<0.05) of patients between low, high and very high-risk categories.
  
  
  CONCLUSIONS
  This tentative study shows that ABI and PAI-1 are associated with the risk of new CVEs in symptomatic ICAD patients, and their combination might improve identification of patients at higher risk.
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
authors: A
authors: A
authors: Massot
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
authors: D
authors: D
authors: Giralt
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
authors: A
authors: A
authors: Penalba
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
authors: T
authors: T
authors: Garcia-Berrocoso
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain.
authors: M
authors: M
authors: Navarro-Sobrino
authors: Neurovascular Unit, Stroke Unit, Department of Neurology, Hospital Clínico, Universitario de Valladolid, Valladolid, Spain.
authors: J F
authors: JF
authors: Arenillas
authors: Neurovascular Unit, Department of Neurology, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital, Barcelona, Spain.
authors: M
authors: M
authors: Ribó
authors: Neurovascular Unit, Department of Neurology, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital, Barcelona, Spain.
authors: C A
authors: CA
authors: Molina
authors: Neurovascular Unit, Department of Neurology, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital, Barcelona, Spain.
authors: J
authors: J
authors: Alvarez-Sabín
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain; Neurovascular Unit, Department of Neurology, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital, Barcelona, Spain.
authors: J
authors: J
authors: Montaner
authors: Neurovascular Research Laboratory, Vall d'Hebron Hospital, Barcelona, Spain. Electronic address: pilar.delgado@vhir.org.
authors: P
authors: P
authors: Delgado
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood; D000368:Aged; D055109:Ankle Brachial Index; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis*; D002546:Ischemic Attack, Transient; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*
chemical_list: D019040:E-Selectin; D017395:Plasminogen Activator Inhibitor 1; D018799:Intercellular Adhesion Molecule-1; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase
keywords: Ankle-brachial index; Biomarkers; Intracranial atherosclerotic disease; Intracranial stenosis; PAI-1