Journal of Stroke and Cerebrovascular Diseases

2016

DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.049

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Low Ankle-Brachial Index is a Simple Physical Exam Sign Predicting Intracranial Atherosclerotic Stenosis in Ischemic Stroke Patients

Nestor Barreto-Neto

¹

,

Alexandre D. Barros

²

,

Pedro Antônio Pereira de Jesus

³

et al.

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Cited by 10 publications

(11 citation statements)

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“…However, in the present study, subjects with local arteriosclerosis had a significantly lower ABI than subjects without local arteriosclerosis. A low ABI indicates narrowing of the arteries both in the lower limbs and in the intracranial region . This evidence appears to support the validity of the assessment of local arteriosclerosis in the present study.…”

Section: Discussionsupporting

confidence: 87%

The association between local arteriosclerosis of the prostatic arteries and chronic inflammation in human benign prostatic enlargement

¹

,

²

,

³

et al. 2019

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Background: To elucidate the pathogenesis of benign prostatic enlargement (BPE) in humans due to chronic inflammation caused by arteriosclerosis, the relationships between prostate size and the degree of chronic inflammation induced by local arteriosclerosis were investigated. Methods: The present cohort included 50 subjects who underwent robot-assisted radical prostatectomy (RARP) in a prospective study. The presence or absence of local arteriosclerosis in the prostatic arteries removed during RARP was evaluated by microscopic assessment. Chronic inflammation in the prostate was judged according to both the density and the extent of inflammatory cells. The expression of lectin-like oxidized-low density lipoprotein receptor-1 (LOX-1) and the infiltration of macrophages in the prostate, which are high in arteriosclerosis, were investigated by immunohistochemistry.Results: Local arteriosclerosis was observed in 28% (14/50). Prostate size and the inflammation score were significantly increased in the presence of arteriosclerosis (P = 0.006, P < 0.001, respectively). There was also a significant increase of LOX-1 in the epithelial and stromal cells of the prostate in the presence of arteriosclerosis (all, P < 0.001). Concerning the presence of macrophages, subjects with arteriosclerosis had significantly more positive expression of ionized calcium-binding adapter molecule-1 (IBA-1), a marker of macrophages, than subjects without arteriosclerosis (P < 0.001). Conclusions:In human surgical specimens, chronic inflammation owing to local arteriosclerosis of the prostatic arteries was significantly related to prostatic enlargement. Given the immunohistochemical analyses, the putative pathogenesis for this relationship is that LOX-1 induces macrophage infiltration, leading to BPE.

“…However, in the present study, subjects with local arteriosclerosis had a significantly lower ABI than subjects without local arteriosclerosis. A low ABI indicates narrowing of the arteries both in the lower limbs and in the intracranial region . This evidence appears to support the validity of the assessment of local arteriosclerosis in the present study.…”

Section: Discussionsupporting

confidence: 87%

The association between local arteriosclerosis of the prostatic arteries and chronic inflammation in human benign prostatic enlargement

¹

,

²

,

³

et al. 2019

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Background: To elucidate the pathogenesis of benign prostatic enlargement (BPE) in humans due to chronic inflammation caused by arteriosclerosis, the relationships between prostate size and the degree of chronic inflammation induced by local arteriosclerosis were investigated. Methods: The present cohort included 50 subjects who underwent robot-assisted radical prostatectomy (RARP) in a prospective study. The presence or absence of local arteriosclerosis in the prostatic arteries removed during RARP was evaluated by microscopic assessment. Chronic inflammation in the prostate was judged according to both the density and the extent of inflammatory cells. The expression of lectin-like oxidized-low density lipoprotein receptor-1 (LOX-1) and the infiltration of macrophages in the prostate, which are high in arteriosclerosis, were investigated by immunohistochemistry.Results: Local arteriosclerosis was observed in 28% (14/50). Prostate size and the inflammation score were significantly increased in the presence of arteriosclerosis (P = 0.006, P < 0.001, respectively). There was also a significant increase of LOX-1 in the epithelial and stromal cells of the prostate in the presence of arteriosclerosis (all, P < 0.001). Concerning the presence of macrophages, subjects with arteriosclerosis had significantly more positive expression of ionized calcium-binding adapter molecule-1 (IBA-1), a marker of macrophages, than subjects without arteriosclerosis (P < 0.001). Conclusions:In human surgical specimens, chronic inflammation owing to local arteriosclerosis of the prostatic arteries was significantly related to prostatic enlargement. Given the immunohistochemical analyses, the putative pathogenesis for this relationship is that LOX-1 induces macrophage infiltration, leading to BPE.

“…This phenomenon was not found in our current study. One study by Barreto-Neto N. and colleagues demonstrated that ABI is independently associated with intracranial atherosclerotic stenosis in a sample of patients with mean age 62 ± 15 years and ischemic stroke ( 8 ). One meta-analysis study showed that in patients at the mean age ranged from 64 to 79 years with acute ischemic stroke, low ABI increased the risk of composite outcomes (myocardial infarction, stroke, or mortality), disability, and mortality ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Ankle-Brachial Index Is Independently Associated With Cardiovascular Outcomes and Foot Ulcers in Asian Patients With Type 2 Diabetes Mellitus

¹

,

²

,

³

et al. 2021

Front. Endocrinol.

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Background and AimsThe ankle-brachial index (ABI) is an efficient tool for objectively documenting the presence of lower-extremity peripheral arterial disease (PAD). The predictive factors of cardiovascular events and diabetic foot ulcer were not clear from the ABI examination in Taiwanese patients with type 2 diabetes mellitus (DM).MethodsWe enrolled 482 patients with type 2 DM who regularly visited the outpatient department of Chang Gung Memorial Hospital and received ABI as well as brachial-ankle pulse wave velocity (ba-PWV) examinations from 2010 to 2017. Age, gender, PAD symptoms, comorbidities, family history of chronic diseases, lifestyle (smoking, alcohol consumption, and exercise), height, weight, waist circumference, monofilament testing and foot ulcer status were studied.ResultsThere were 104 (22%) patients (mean age, 67.8 years) with the ABI <1.0. These patients with low ABI (ABI<1.0) had a significantly older age (p=0.001), higher delta PWV (p<0.001), higher rates of stroke (p=0.007), myocardial infarction (p=0.016), and foot ulcer (p=0.039). In a multivariable analysis model, the adjusted odds ratio (aOR) for myocardial infarction, stroke, and foot ulcers associated with low ABI were 1.219 (0.397-3.743, p=0.729), 1.204 (0.556-2.610, p=0.638), and 2.712 (1.199-6.133, p=0.017), respectively. The patients with low PWV (PWV<1400 cm/s) were significantly younger (p<0.001) and had a lower rate of hypertension (p<0.001), and higher percentages of stroke (p=0.027) and dialysis (p=0.041) family history.ConclusionsLow ABI was associated with cardiovascular events and diabetic foot ulcer independently in patients with type 2 DM.

“…The percentage of low ABI was only 16% in the control group. According to available data, 9 to 51% of patients with acute ischemic strokes have concurrent LEAD [ 9 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Busch et al observed 204 patients with IS or TIA over two years.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Lower Extremity Arterial Disease as Measured by Low Ankle-Brachial Index in Patients with Acute Cerebral Ischemic Events

Konieczna-Brazis¹,

²

,

³

et al. 2020

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Background: Low ankle–brachial index (ABI) of ≤0.9 is diagnostic of lower extremity arterial disease (LEAD). It is also a strong marker of generalized atherosclerosis. The objective of this study was to assess the prevalence of low ABI in patients with acute cerebral ischemic events (ACIE): ischemic stroke (IS) or transient ischemic attack (TIA). Methods: We compared 150 inpatients with ACIE to 50 inpatient controls and assessed risk factors, ABI measurements, and Duplex ultrasound of the cervical vessels. Results: Low ABI was seen in 69 patients (46%) in the ACIE group and in 8 (16%) in the control group; p < 0.01. The mean and median ABI values in the ACIE group were 0.88 (SD = 0.22) and 0.91 (0.24–1.33), which were significantly lower than in the control group: 1.04 (SD = 0.16) and 1.0 (0.66–1.36); p < 0.0001, respectively. Coronary artery disease, carotid stenosis of ≥50% and smoking were risk factors, which were associated with significantly lower ABI in the study group; the ABI with risk factors vs. without was 0.85 vs. 0.92 (coronary artery disease); p < 0.05, 0.7 vs. 0.92; (carotid stenosis) p < 0.001 and 0.83 vs. 0.98; (smoking) p < 0.001, respectively. Conclusion: Our study demonstrated that patients with ACIE have significantly higher involvement of another vascular bed as LEAD. Coronary artery disease, carotid stenosis ≥50% and smoking were main risk factors associated with coexistence of LEAD and ACIE.

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