Prognostic implications of the Ankle Brachial Index in patients with acute ischemic stroke: A meta-analysis

ABSTRACT

Background: The ankle brachial index (ABI) is recognized as a marker of atherosclerotic disease. The detection of ABI may improve the risk stratification.

Methods: We systematically searched Pubmed and Embase (from the earliest date to October 2015) for studies evaluating the prognostic value of ABI in patients with acute ischemic stroke. Stroke or cardiovascular events, mortality and functional outcomes were analyzed.

Results: Seventeen studies, containing 9404 patients, were included. The mean age of participants in each study ranged from 64 to 79 years. The prevalence of low ABI varied from 7.4% to 40.5%. In this quantitative analysis, we found that low ABI increased the risk of composite outcomes (myocardial infarction or stroke or mortality), disability and mortality.

Conclusion: The detection of ABI may help to identify high-risk patients for secondary stroke prevention.

KEYWORDS:

• Acute ischemic stroke
• Ankle-Brachial Index
• prognosis
• meta-analysis

Financial & competing interests disclosure

This research was supported by the Science and technology infrastructure projects of Sichuan Province (NO.2012JCPT008). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• The ABI is an easy and reliable tool to identify patients with subclinical PAD. It is also recognized as an important marker of atherosclerotic disease.

• The detection of PAD may improve the risk stratification and prevention of future vascular events.

• A systematic review was performed to assess the association between low ABI and adverse outcomes in patients with acute ischemic stroke

• Up to 40% of patients hospitalized for an acute ischemic stroke have low ABI. Low ABI was an independent predictor of composite outcomes (MI or stroke or mortality), disability and mortality after acute ischemic stroke.

• The detection of ABI may help identify high-risk patients for secondary stroke prevention.