title: Ankle-brachial index and neurologic deterioration in acute ischemic stroke.
abstract: BACKGROUND
  Few studies have examined the relationship between abnormal ankle-brachial index (ABI) and short-term outcome in patients with acute ischemic stroke (AIS).
  
  
  METHODS
  We included 209 consecutive patients with AIS admitted to our hospital and divided them into abnormal ABI (≤.9) and normal ABI (>.9) groups. We defined neurologic deterioration (ND) as an increase of 1 or more points in the National Institutes of Health Stroke Scale score within 7 days of stroke onset. Clinical characteristics were compared between the 2 groups. Then, we performed a multiple logistic regression analysis to identify independent predictors of ND. In the multivariate analysis, the ABI values were used separately as binary variables in different cutoff thresholds (.9, 1.0, and 1.1).
  
  
  RESULTS
  Of the 209 patients, 24 (11.5%) had an abnormal ABI. The patients in abnormal and normal ABI groups showed significant differences in carotid arterial stenosis (37.5% versus 18.9%; P = .040), intracranial artery stenosis (54.2% versus 18.9%; P < .001), and previous use of antiplatelet drugs (58.3% versus 29.2%; P = .004). According to the multivariate analysis, ABIs of .9 or less and 1.0 or less were positively associated with ND (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.03-2.89; P = .034 and OR, 1.63; 95% CI, 1.05-2.54; P = .027, respectively), whereas an ABI value of 1.1 or less was not an independent predictor of ND (OR, 1.17; 95% CI, 0.79-1.74; P = .43).
  
  
  CONCLUSIONS
  Not only an ABI of .9 or less but also an ABI of 1.0 or less can be a predictor of ND in patients with AIS.
authors.affiliation: Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. Electronic address: kishizuka@nij.twmu.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ishizuka
authors.affiliation: Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Hoshino
authors.affiliation: Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uchiyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000503:physiopathology*
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Acute ischemic stroke; ankle-brachial index; atherosclerosis; neurologic deterioration; progressive stroke