Prevalences of Peripheral Arterial Disease Diagnosed by Computed Tomography Angiography in Patients with Acute Ischemic Stroke

• Published in: Journal of stroke and cerebrovascular diseases Vol. 25; no. 5; pp. 1128 - 1134
• Main Authors: Naito, Hiroyuki, MD, Naka, Hiromitsu, MD, PhD, Kobayashi, Megumi, MD, Kanaya, Yuhei, MD, Naito, Kasane, MD, Kurashige, Takashi, MD, PhD, Tokinobu, Hiroshi, MD, Matsumoto, Masayasu, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Acute ischemic stroke; Aged; Aged, 80 and over; ankle brachial index; Atrial Fibrillation - epidemiology; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Cardiovascular; Comorbidity; Computed Tomography Angiography; Female; Humans; Intracranial Embolism - diagnosis; Intracranial Embolism - epidemiology; Japan - epidemiology; Male; Middle Aged; Neurology; peripheral arterial disease; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - epidemiology; Predictive Value of Tests; Prevalence; Prospective Studies; Risk Factors; Stroke - diagnosis; Stroke - epidemiology; computed tomography angiography; peripheral arterial disease; Acute ischemic stroke; ankle brachial index
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2016.01.029

Background Few studies have examined the prevalence of peripheral arterial disease (PAD) with the use of computed tomography angiography (CTA) in patients with acute ischemic stroke (AIS), although several reports have examined its prevalence using an ankle brachial index (ABI). We aimed to determine the prevalence of PAD indicated by CTA in patients with AIS and to clarify the prevalence of PAD in each clinical ischemic stroke subtype. Methods We included 199 consecutive patients with AIS admitted to our hospital and divided them into PAD and non-PAD groups according to the CTA findings. Results Of the 199 patients, 40 (20.1%) had PAD; 27 (67.5%) of the PAD patients were asymptomatic. The prevalence of abnormal ABI (≤.9) was 12.2%. Patients with PAD were older (78.3 ± 10.2 versus 71.5 ± 10.9, P  <   .001) and had a significantly lower ABI value (.89 ± .24 versus 1.15 ± .09, P  <   .001) and higher prevalence of diabetes mellitus (50.0% versus 31.4%, P  = .028), atrial fibrillation (40.0% versus 16.4%, P  = .001), coronary artery disease (32.5% versus 8.2%, P  <   .001), and intracranial arterial stenosis (47.5% versus 28.9%, P  = .025) than patients without PAD. The prevalence of cerebral microbleeds was not different between patients with PAD and those without PAD (25.6% versus 25.4%, P  = .985). The prevalence of PAD among ischemic stroke subtypes was highest in patients with cardioembolic infarction (40.5%). Conclusions Almost one fourth of the AIS patients examined had PAD on CTA. Cardioembolic infarction patients showed the highest prevalence of PAD among the clinical ischemic subtypes, suggesting the coexistence of atheromatous diseases and atrial fibrillation.