Prevalence and association between risk factors, stroke subtypes, and abnormal ankle brachial index in acute ischemic stroke

Background: Abnormal ankle brachial index (ABI) identifies a stroke subgroup with high risk of subsequent stroke and other vascular events. There are few data regarding the prevalence of abnormal ABI in ischemic stroke in Asian countries. Methods: We evaluated the prevalence of abnormal ABI in 747 Thai patients with ischemic stroke or transient ischemic attack and assessed the correlation of abnormal ABI with stroke risk factors and stroke subtypes. Results: The prevalence of abnormal ABI (≤0.9) in ischemic stroke patients was 18.1%. Abnormal ABI in ischemic stroke patients was significantly correlated with female gender (odds ratio [OR], 1.61; confidence interval [CI], 1.09-2.40; P =.017), age ≥ 60 years (OR, 3.54; CI, 2.14-5.85; P <.001), and previous ischemic events, including coronary artery disease (OR, 2.55; CI, 1.47-4.43; P =.001), cerebrovascular disease (OR, 2.15; CI, 1.37-3.55; P =.002), and atrial fibrillation (OR, 1.71; CI, 1.03-2.82; P =.036). There was a significant difference in the prevalence of abnormal ABI among stroke subtypes (P <.001), which tended to be more frequent in those with large artery disease (20.4%), cardioembolic stroke (29.2%), and undetermined etiology (20.6%). Conclusions: An ABI examination should be considered in patients with ischemic stroke to facilitate the early detection and treatment of asymptomatic peripheral arterial disease and identification of excess risk for subsequent stroke or other vascular events.