Predicting Stroke Outcomes Using Ankle-Brachial Index and Inter-Ankle Blood Pressure Difference

Area of Science:

• Vascular Medicine
• Neurology
• Cardiology

Background:

• Investigating the prognostic value of hemodynamic markers in acute ischemic stroke patients.
• Focus on ankle-brachial index difference (ABID) and systolic inter-ankle blood pressure difference (IAND) in patients without peripheral artery disease (PAD).

Purpose of the Study:

• To determine the association of high ABID and IAND with short-term and long-term outcomes in acute ischemic stroke patients without PAD.
• To evaluate the predictive value of these blood pressure differentials for functional outcomes, major adverse cardiovascular events (MACE), and mortality.

Main Methods:

• Prospective enrollment of consecutive acute ischemic stroke patients undergoing ankle-brachial index (ABI) measurement.
• Calculation of ABID as the absolute difference between right and left ABI.
• Calculation of IAND as the absolute difference between right and left systolic blood pressure.
• Assessment of poor functional outcome (modified Rankin Scale score ≥3 at 3 months) and MACE (stroke recurrence, myocardial infarction, or death).

Main Results:

• A cohort of 2901 patients was analyzed, with 2643 (84.9%) confirmed to have no PAD.
• High ABID (≥0.15) and IAND (≥15 mmHg) were independently associated with poor functional outcome.
• Both high ABID and IAND were independently associated with increased risk of MACE and all-cause mortality in patients without PAD.

Conclusions:

• Elevated ABID and IAND are significant predictors of adverse outcomes in acute ischemic stroke patients without PAD.
• These simple blood pressure measurements can aid in risk stratification for functional recovery, cardiovascular events, and mortality.