Combination of High Ankle–Brachial Index and Hard Coronary Heart Disease Framingham Risk Score in Predicting the Risk of Ischemic Stroke in General Population

Abstract

Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9<ABI<1.3). Biochemical parameters, clinical characteristics and 10-year hard coronary heart disease (HCHD) Framingham Risk Score (FRS) were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87±6.11 vs. 3.98±2.90%, P<0.001). There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01). The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05), and it was higher in participants with HCHD FRS≥6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05). Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS≥6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05). BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China.

Levels of ankle–brachial index and the risk of diabetes mellitus complications

“…ABI levels defined exposure, categorized as follows: 0.4≤ABI<0.5, 0.5≤ABI<0.7, 0.7≤ABI<0.9, 0.9≤ABI<1.1, 1.1≤ABI<1.3, and 1.3≤ABI. We presented the ABI values in categories because previous reports showed a J shape in the relation of ABI with mortality8 24 and hypothesized that a similar distribution might occur with other outcomes 25. Instead of the subdivisions of the ABI values by ranges of 0.1, we merged some categories to ensure enough number of participants in each group.…”

Correlation study of Framingham risk score and vascular dementia

“…The sample size was calculated by taking the previously quoted study into account. [ 19 , 20 ] A significance level of 5% for a 2-sided t- test with a 80% power (1-β), 52 patients were required in each group. Assuming a 20% drop-out rate, we planned to randomize 60 patients to each group…”

Risiko Penyakit Kardiovaskuler Pada Peserta Program Pengelolaan Penyakit Kronis (Prolanis) Di Puskesmas Kota Bima: Korelasinya Dengan Ankle Brachial Index Dan Obesitas

“…ABI juga merupakan indikator dari aterosklerosis umum karena nilai ABI yang lebih rendah/lebih tinggi berkaitan dengan risiko tinggi terjadinya penyakit koroner dan serebrovaskular. Sesuai dengan hasil penelitian yang menunjukkan bahwa risiko PKV dengan FRS dalam 10 tahun dari kelompok ABI tinggi secara signifikan lebih tinggi daripada kelom-pok ABI normal (7,87 ± 6,11 vs 3,98 ± 2,90%, P <0,001), ( Zhang, et al, 2014).…”

“…FRS sering dianggap sebagai standar referensi tetapi memiliki ketepatan yang terbatas yaitu cenderung terlalu memperkirakan risiko pada populasi berisiko rendah dan kurang perkiraan dalam populasi berisiko tinggi. Penggabungan penanda risiko lainnya seperti sindrom metabolik dan ABI telah berhasil secara parsial dalam meningkatkan prediksi (Zhang, et al, 2014). Penggunaan FSR dalam penelitian ini juga dibatasi oleh subvariabel penilaian yang membutuhkan hasil pemeriksaan laboratorium yaitu kolesterol total dan kolesterol HDL yang tentunya tidak dapat dilakukan sendiri oleh masyarakat umum sehingga perlu dipertimbangkan penggunaan alat ukur penilaian risiko yang lebih sederhana dan dapat dilakukan oleh masyarakat/ kelompok berisiko dengan bimbingan petugas kesehatan/kader kesehatan.…”