Ankle–brachial index predicts stroke in the general population in addition to classical risk factors

Abstract Background Predictors of future stroke events gain importance in vascular medicine. Herein, we investigated the value of the ankle-brachial index (ABI), a simple non-invasive marker of atherosclerosis, as stroke predictor in addition to established risk factors that are part of the Framingh...

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Bibliographic Details
Published in:Atherosclerosis 2014-04, Vol.233 (2), p.545-550
Main Authors: Gronewold, Janine, Hermann, Dirk M, Lehmann, Nils, Kröger, Knut, Lauterbach, Karl, Berger, Klaus, Weimar, Christian, Kälsch, Hagen I.M, Moebus, Susanne, Jöckel, Karl-Heinz, Bauer, Marcus, Erbel, Raimund
Format: Article
Language:English
Subjects:
Aged
Ankle Brachial Index
Blood Pressure
Brain Ischemia - epidemiology
Brain Ischemia - physiopathology
Cardiovascular
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Diabetes Mellitus - epidemiology
Female
Follow-Up Studies
Forecasting
Germany - epidemiology
Humans
Male
Middle Aged
Peripheral artery disease
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Smoking - epidemiology
Stroke - epidemiology
Stroke - physiopathology
Stroke prediction
Subclinical atherosclerosis
Urban Population
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Summary:Abstract Background Predictors of future stroke events gain importance in vascular medicine. Herein, we investigated the value of the ankle-brachial index (ABI), a simple non-invasive marker of atherosclerosis, as stroke predictor in addition to established risk factors that are part of the Framingham risk score (FRS). Methods 4299 subjects from the population-based Heinz Nixdorf Recall study (45–75 years; 47.3% men) without previous stroke, coronary heart disease or myocardial infarcts were followed up for ischemic and hemorrhagic stroke events over 109.0 ± 23.3 months. Cox proportional hazard regressions were used to evaluate ABI as stroke predictor in addition to established vascular risk factors (age, sex, systolic blood pressure, LDL, HDL, diabetes, smoking). Results 104 incident strokes (93 ischemic) occurred (incidence rate: 2.69/1000 person-years). Subjects suffering stroke had significantly lower ABI values at baseline than the remaining subjects (1.03 ± 0.22 vs. 1.13 ± 0.14, p  13%) and intermediate (8–13%) FRS tercile. In these subjects, stroke incidence was 28.13 and 8.13/1000 person-years, respectively, for ABI 
ISSN:0021-9150
1879-1484
DOI:10.1016/j.atherosclerosis.2014.01.044