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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