Relationship between Ankle Brachial Index (ABI), High Sensitivity C-Reactive Protein (hs-CRP) and Initial Disability Level in Acute Ischemic Stroke
Songkram Chotik-anuchit MD*, Yongchai Nilanont MD*, Niphon Poungvarin MD, FRCP, FRI*
Affiliation : * Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Relationship between high sensitivity C-reactive protein (hs-CRP), Ankle Brachial index (ABI), severity of
atherosclerosis and risk of ischemic stroke has been well documented. Studies concerning the association of ABI, hs-CRP and
initial disability level in acute ischemic stroke are scarce.
Objective : This study aimed to investigate the relationship between hs-CRP, ABI and level of initial disability in acute stroke
setting.
Material and Method: We conducted a prospective observational study in patients with acute ischemic stroke within 48 hours
of onset. Initial ABI, hs-CRP were measured. Disability level was assessed at admission and 3 months using the modified
Rankin scale (mRS) and the National Institue of Health Stroke scale (NIHSS). Statistical analysis was performed using
Pearson’s correlation coefficient.
Results : This study included 36 patients with a mean + SD age of 67.8 + 9.3 years. Sixteen (44.4%) were male. Median NIHSS
and mRS were 10 and 4 respectively. Correlation between initial ABI and hs-CRP was poor (rs=-0.11, p= 0.57). There was
a significant negative relationship between ABI and mRS at 0 and 3 months with a correlation coefficient of -0.45 (p = 0.006)
and -0.41 (p = 0.02), respectively.
Conclusion : There was a significant inverse relationship between ABI and initial stroke disability. However, correlation
coefficient indicated only fair agreement beyond chance. This findings suggest that ABI may be used as a clinical predictor of
initial disability level in acute stroke.
Keywords : Acute ischemic stroke, Ankle brachial index (ABI), High sensitivity C-reactive protein (hs-CRP), modified Rankin scale (mRS)
