Document Detail

High prevalence of peripheral arterial disease in patients with acute ischaemic stroke.
MedLine Citation:
PMID:  20029198     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: After acute ischaemic stroke (AIS) or transient ischaemic attack (TIA), the detection of peripheral arterial disease (PAD) as a marker of generalized atherosclerosis may improve the risk stratification and prevention of future atherothrombotic events. We aimed to determine the prevalence of PAD indicated by an ankle-brachial index (ABI) of < or =0.9 in a large cohort of patients with AIS/TIA. METHODS: In this prospective, multicentre, Austrian, cross-sectional study (OECROSS), 759 patients with AIS or TIA were recruited for a systematic assessment of cardiovascular risk profiles and Doppler ultrasound at the ankle and brachial artery to calculate the ABI from systolic blood pressure readings. RESULTS: 739 patients (97.4%) had a complete ABI assessment. The mean age was 69.5 (+/- 12.1) years, and 55.8% of the patients were men. 81.6% of the patients had AIS and 18.4% had TIA. Only 6.2% of the patients had a history of PAD, but an abnormal ABI of < or =0.9 was found in 44.9%. Patients with an ABI of < or =0.9 were more likely (p < 0.05) to be older and have a history of PAD, hypertension, diabetes and congestive heart failure. An ABI of < or =0.9 was significantly associated (p < 0.0005) with a presence of carotid stenosis of >50% and an Essen Stroke Risk Score of >2, indicating a risk of > or =4% per year of stroke recurrence. DISCUSSION: A high proportion of patients with AIS/TIA have subclinical PAD, a cross-risk stroke physicians should be aware of. Large longitudinal studies are needed to elucidate whether the ABI can improve our estimation of the risk of future atherothrombotic events and help in optimizing secondary prevention.
Raffi Topakian; Sylvia Nanz; Bernhard Rohrbacher; Renate Koppensteiner; Franz T Aichner;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-12-18
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  29     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2009-12-23     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  248-54     Citation Subset:  IM    
Copyright Information:
Copyright 2009 S. Karger AG, Basel.
Department of Neurology, Academic Teaching Hospital Wagner-Jauregg, Linz, Austria.
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MeSH Terms
Aged, 80 and over
Ankle / blood supply
Austria / epidemiology
Blood Pressure
Brachial Artery / physiopathology
Brain Ischemia / complications*,  epidemiology,  physiopathology
Cross-Sectional Studies
Middle Aged
Peripheral Vascular Diseases / complications*,  epidemiology,  physiopathology
Prospective Studies
Risk Assessment
Risk Factors
Stroke / epidemiology,  etiology*,  physiopathology
Ultrasonography, Doppler

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