Universität zu Köln

Gronewold, Janine, Hermann, Dirk M., Lehmann, Nils, Kroeger, Knut, Lauterbach, Karl, Berger, Klaus, Weimar, Christian, Kaelsch, Hagen I. M., Moebus, Susanne, Joeckel, Karl-Heinz, Bauer, Marcus and Erbel, Raimund (2014). Ankle-brachial index predicts stroke in the general population in addition to classical risk factors. Atherosclerosis, 233 (2). S. 545 - 551. CLARE: ELSEVIER IRELAND LTD. ISSN 1879-1484

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Abstract

Background: Predictors of future stroke events gain importance in vascular medicine. Herein, we investigated the value of the ankle-brachial index (ABI), a simple non-invasive marker of atherosclerosis, as stroke predictor in addition to established risk factors that are part of the Framingham risk score (FRS). Methods: 4299 subjects from the population-based Heinz Nixdorf Recall study (45-75 years; 47.3% men) without previous stroke, coronary heart disease or myocardial infarcts were followed up for ischemic and hemorrhagic stroke events over 109.0 +/- 23.3 months. Cox proportional hazard regressions were used to evaluate ABI as stroke predictor in addition to established vascular risk factors (age, sex, systolic blood pressure, LDL, HDL, diabetes, smoking). Results: 104 incident strokes (93 ischemic) occurred (incidence rate: 2.69/1000 person-years). Subjects suffering stroke had significantly lower ABI values at baseline than the remaining subjects (1.03 +/- 0.22 vs. 1.13 +/- 0.14, p < 0.001). In a multivariable Cox regression, ABI predicted stroke in addition to classical risk factors (hazard ratio = 0.77 per 0.1, 95% confidence interval = 0.69-0.86). ABI predicted stroke events in subjects above and below 65 years, both in men and women. ABI specifically influenced stroke risk in subjects belonging to the highest (>13%) and intermediate (8-13%) FRS tercile. In these subjects, stroke incidence was 28.13 and 8.13/1000 person-years, respectively, for ABI < 0.9, compared with 3.97 and 2.07/1000 person-years for 0.9 <= ABI <= 1.3. Conclusions: ABI predicts stroke in the general population, specifically in subjects with classical risk factors, where ABI identifies subjects at particularly high stroke risk. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gronewold, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermann, Dirk M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Knut UNSPECIFIED UNSPECIFIED UNSPECIFIED Lauterbach, Karl UNSPECIFIED UNSPECIFIED UNSPECIFIED Berger, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Weimar, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaelsch, Hagen I. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moebus, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Joeckel, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Marcus UNSPECIFIED UNSPECIFIED UNSPECIFIED Erbel, Raimund UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-441407
DOI:	10.1016/j.atherosclerosis.2014.01.044
Journal or Publication Title:	Atherosclerosis
Volume:	233
Number:	2
Page Range:	S. 545 - 551
Date:	2014
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1879-1484
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERIPHERAL ARTERIAL-DISEASE; HEINZ NIXDORF RECALL; INTIMA-MEDIA-THICKNESS; CARDIOVASCULAR EVENTS; ISCHEMIC-STROKE; MORTALITY; ATHEROSCLEROSIS; CALCIFICATION; PREVENTION; SCORE Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44140