Deans' stroke musings: Ankle-brachial index and recurrent stroke risk

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, February 6, 2016

Ankle-brachial index and recurrent stroke risk

No clue on what this means but once again we have researchers trying to predict stroke risk rather than solving all the problems in stroke. If we had anything other than our fucking failures of stroke associations we would have a stroke strategy defined that would systematically solve all the problems in stroke. But NO, we will be screwed for decades because NO ONE is in charge.

Ankle-Brachial Index Test

http://www.mdlinx.com/internal-medicine/medical-news-article/2016/01/29/ankle-brachial-index-ischemic-attack-transient/6509573/?news_id=881&newsdt=020616&subspec_id=488&utm_source=WeeklyNL&utm_medium=newsletter&utm_content=Weeks-Best-Article&utm_campaign=article-section&category=latest-weekly

In this systematic review and meta–analysis, the authors sought to explore ankle–brachial index (ABI)’s merit as a marker for stroke recurrence and vascular risk by synthesizing the data currently available in stroke literature. The results confirm the positive association between ABI and stroke recurrence. Further studies are needed to see whether inclusion of ABI will help improve the accuracy of prediction models and management of stroke patients.

Methods

The authors searched Embase, MEDLINE, and Pubmed databases for prospective cohort studies that included consecutive patients with stroke and transient ischemic attack, measured ABI at baseline, and performed a follow-up assessment at least 12 months after initial stroke or transient ischemic attack.
The following end points were chosen for their analysis: recurrent stroke and combined vascular end point (recurrent vascular event or vascular death).
Crude risk ratios and adjusted Cox proportional hazard ratios were combined separately using the random-effects model.
Study-level characteristics (eg, percent of cohort with a history of hypertension, average cohort age, level of adjustment, and mean follow-up duration) were included as covariates in a metaregression analysis.

Results

The authors identified 11 studies (5374 patients) that were not significantly heterogeneous.
Pooling adjusted hazard ratios showed that low ABI was associated with both an increased hazard of recurrent stroke (hazard ratio, 1.70; 95% confidence interval, 1.10-2.64) and an increased risk of vascular events or vascular death (hazard ratio, 2.22; 95% confidence interval, 1.67-2.97).

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