Low ankle-brachial index and risk of stroke

ObjectiveMany studies have evaluated the association between a low ankle-brachial index (ABI) and the risk of stroke events; however, their results are inconsistent. The aim of the present study was to determine the association between a low ABI (ABI < 0.9) and the risk of stroke events by conducting a meta-analysis.MethodsElectronic literature databases (Medline, and Embase) were searched for relevant prospective observational studies published prior to December 2012. Only prospective studies that detected stroke events for participants with low ABI in general population during the follow-up period were selected. The results were presented as relative risk (RR) and the 95% confidence interval (CI) comparing low ABI (ABI < 0.9) to the ABI (≥0.9) category.ResultsAfter the initial search, we identified 10 studies with a total of 22,355 participants that met our inclusion criteria. Overall, low ABI was associated with an increased risk of subsequent stroke (RR 1.43; 95% CI 1.23-1.65), and ischemic stroke (RR 1.83; 95% CI 1.29-2.58). In addition, a low ABI was also associated with an increased risk of recurrent strokes (RR 3.02; 95% CI 1.26-7.25). However, a low ABI was not associated with an increased risk of hemorrhagic stroke (RR 1.55; 95% CI 0.34-7.08).ConclusionsOur results suggest that a low ABI appears to be an independent predictor for ischemic and recurrent stroke events. The low ABI provides supplemental information on subjects who are at increased risk of subsequent stroke events.