Ischaemic stroke and peripheral artery disease
Attiya Sabeen Rahman1, Syed Wasim Akhtar1, Qaiser Jamal1
1KMDC.
Insights
Peripheral artery disease, indicated by a low ankle-brachial index, affects 18.3% of ischemic stroke patients. This study assessed atherosclerosis in stroke patients, finding a significant prevalence of peripheral artery disease.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Vascular Biology
Background:
- Ischemic stroke is a major cause of disability and mortality worldwide.
- Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis.
- The ankle-brachial index (ABI) is a non-invasive test to assess PAD.
Purpose of the Study:
- To determine the frequency of atherosclerosis using the ankle-brachial index in patients with ischemic stroke.
- To evaluate the association between carotid artery stenosis and ankle-brachial index in ischemic stroke patients.
Main Methods:
- A cross-sectional study involving 327 patients diagnosed with ischemic stroke.
- Patients were classified using the Asian stroke criteria.
- Primary outcome measures included carotid artery stenosis and ankle-brachial index; data analyzed using SPSS 20.
Main Results:
- Peripheral artery disease was detected in 18.3% of the study population.
- Mild carotid artery stenosis was present in 55.6% of patients, moderate in 42.8%, severe in 0.9%, and complete occlusion in 0.6%.
- PAD prevalence was similar in patients with mild (17.5%) and moderate (17.8%) carotid artery stenosis.
Conclusions:
- Abnormally low ankle-brachial index, indicative of subclinical peripheral artery disease, was found in 18% of ischemic stroke patients.
- Atherosclerosis, assessed by ABI, is common in patients with ischemic stroke.
- Findings highlight the importance of assessing for PAD in stroke patients.
Objective:
To determine the frequency of atherosclerosis by ankle brachial index in patients with an ischaemic stroke and to assess the association of carotid artery stenosis and ankle brachial index in ischaemic stroke.
Methods:
This cross-sectional study was conducted at Abbasi Shaheed Hospital, Karachi, from July 2011 to May 2014, and comprised patients with ischaemic stroke. The patients were classified according to the Asian stroke criteria for classification of brain infarction. Primary outcome measures included carotid artery stenosis and ankle brachial index. The other independent variables were age, gender, body mass index and waist circumference. SPSS 20 was used for data analysis.
Results:
A total of 327 patients were enrolled. The overall mean age was 57.6±12.8 years. Besides, 168(51.3%) participants were males. Peripheral artery disease was found in 60(18.3%) patients. Mild carotid artery stenosis was found in 182(55.6%) patients, moderate in 140(42.8%), severe in 3(0.9%) and complete occlusion in 2(0.6%) patients. In patients having mild carotid artery stenosis, 32(17.5%) had peripheral artery disease, whereas in patients with moderate carotid artery stenosis, 25(17.8%) had peripheral artery disease.
Conclusions:
Abnormally low ankle brachial index suggesting subclinical peripheral artery disease was 18%.
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