The prevalence of peripheral arteriopathy is higher in ischaemic stroke as compared with transient ischaemic attack and intracerebral haemorrhage

• Published in: International journal of stroke 2010-08, Vol.5 (4), p.278-283
• Main Authors: Huttner, Hagen B., Köhrmann, Martin, Mauer, Christoph, Lücking, Hannes, Kloska, Stephan, Doerfler, Arnd, Schwab, Stefan, Schellinger, Peter D.
• Format: Article
• Language: English
• Subjects: Acute ischemic stroke; Aged; Analysis of Variance; Blood Pressure - physiology; Brain Ischemia - complications; Brain Ischemia - diagnostic imaging; Brain Ischemia - pathology; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - pathology; Cohort Studies; Cross-Sectional Studies; Diabetic Angiopathies - complications; Female; Glycated Hemoglobin A - analysis; Humans; Hypertension - complications; Ischemic Attack, Transient - complications; Ischemic Attack, Transient - diagnostic imaging; Ischemic Attack, Transient - pathology; Lipids - blood; Male; peripheral artery disease; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - diagnostic imaging; Peripheral Vascular Diseases - pathology; Regression Analysis; Risk Factors; Smoking - epidemiology; Socioeconomic Factors; Stroke - diagnostic imaging; Stroke - etiology; Stroke - pathology; Tomography, X-Ray Computed; Ultrasonography, Doppler, Transcranial
• ISSN: 1747-4930; 1747-4949
• DOI: 10.1111/j.1747-4949.2010.00440.x

Background: There is little data on the association of peripheral arterial disease and stroke. We aimed to assess the prevalence of peripheral arterial disease in acute stroke and to identify the predisposing factors for peripheral arterial disease in a stroke cohort. Methods: We enrolled all consecutive patients who were admitted to our stroke- and neurocritical care units with the diagnosis of a transient ischaemic attack, ischaemic or haemorrhagic stroke over a period of 5 months. As controls, we analysed 50 nonvascular neurological patients who were matched to age. Upon admission, assessment of the ankle brachial index was performed in all patients. The only exclusion criteria was decompensated congestive heart failure. Results: Altogether, we compared 374 stroke patients (95 transient ischaemic attack, 231 ischaemic, and 48 haemorrhagic strokes) and 50 nonstroke controls. The prevalence of peripheral arterial disease in the control group was 14%. There was a trend towards a higher prevalence of peripheral arterial disease in stroke patients (χ2-test: P = 0.051; prevalence peripheral arterial disease in transient ischaemic attack: 16.8%, ischaemic stroke: 32%, and haemorrhagic stroke: 20.8%). A higher proportion of ischaemic stroke patients were peripheral arterial disease-positive, compared with transient ischaemic attack patients (P = 0.005) and controls (P = 0.011), respectively. Multivariate regression analyses identified the parameters age, arterial hypertension, current or former smokers and a history of cardiovascular events to be predisposing factors of peripheral arterial disease. Conclusion: This study represents the first systematic investigation of the prevalence of peripheral arterial disease in stroke. By now, it is clear that: • peripheral arterial disease is more commonly found in stroke than in nonstroke patients • ischaemic stroke patients show the highest prevalence of peripheral arterial disease, and • peripheral arterial disease in stroke is related to common vascular risk factors.