Abstract W P143: Ankle-brachial Index Predicts Extracranial Vascular Events After Transient Ischemic Attacks. Data From The Promapa Study

The ankle brachial index (ABI) is a known measure of lower-limb peripheral artery disease (PAD), as well as an independent predictor of vascular events. Various methods of ABI calculation have been described. The traditional method (ABI-TM) uses the higher ankle pressure as a numerator and it results in higher specificity. The alternative method (ABI-AM) takes the lower ankle pressure as numerator. It is associated with better sensitivity. Our goal was to compare the prognostic value of abnormal ABI (ABI <=0.9), determined by the two methods, in order to predict subsequent stroke and extracranial vascular events (EVE) in transient ischemic attack (TIA) patients from a multicenter study. Methods: We analyzed data from consecutive 1137 patients with TIA from the multicenter PROMAPA study in which ABI was determined. We determined risk of stroke recurrence (SR) and EVE (ischemic cardiopathy or peripheral arterial disease) at one year of follow up. Results: A total of 616 (54.2%) subjects fulfilled all inclusion criteria. The risk of SR and EVE was 4.7% and 2.1%, respectively. The proportion of abnormal ABI differed according to the method used: 11.5% ABI-TM versus 38.0 ABI-AM (p=0.001). In both situations, abnormal ABI was related to the association of >1 risk factors and large artery atherosclerosis. SR was not predicted by abnormal ABI. However, only abnormal ABI-AM was significantly associated with EVE (p=0.003). Cox proportional-hazards multivariate analyses identify the association of > 1 risk factors (Hazard Ratio [HR] 4.7, 95% CI 1.1-21.2. p=0.045) and abnormal ABI-AM (HR 4.0, 95% CI 1.1-14.6, p=0.035) as independent predictors of EVE. Conclusion: ABI using the lower ankle pressure as numerator is associated with EVE after TIA. The measurement of ABI using the lower ankle pressure as numerator among TIA patients appeared to be useful to identify patients with risk of EVE and to plan adequate prevention therapies or specific diagnostic protocols. ![][1] [1]: /embed/graphic-1.gif