title: Low ankle-brachial index and risk of stroke.
abstract: OBJECTIVE
  Many 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.
  
  
  METHODS
  Electronic 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.
  
  
  RESULTS
  After 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).
  
  
  CONCLUSIONS
  Our 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.
authors.affiliation: Department of Neurology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Fan
authors.forename: Xinhua
authors.initials: X
authors.lastname: Hu
authors.forename: Weidong
authors.initials: W
authors.lastname: Yu
authors.forename: Hui
authors.initials: H
authors.lastname: Cao
authors.forename: Junpeng
authors.initials: J
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D055109:Ankle Brachial Index / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000453:epidemiology* / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology
keywords: Ankle-brachial index; Meta-analysis; Stroke