Ankle-brachial index in screening for asymptomatic carotid and intracranial atherosclerosis

M. Jiménez, L. Dorado, M. Hernández-Pérez, M. T. Alzamora, G. Pera, P. Torán, M. Gomis, N. Pérez de la Ossa, M. Millán, D. Escudero, A. Dávalos, J. F. Arenillas, E. López-Cancio

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22 Citations (Scopus)


Objective: To evaluate usefulness of ankle-brachial index (ABI) in the screening for asymptomatic cervico-cerebral atherosclerosis (CCA) against traditional vascular risk assessment. Methods: This study included a random population sample of 933 Caucasians without prior cardiovascular disease but with a moderate and high vascular risk (REGICOR score 5-9% and ≥10%). Presence and degree of CCA was evaluated by color-coded duplex and significant stenosis >50% (SCCA) confirmed by MRA. Results: Prevalence of significant carotid and/or intracranial stenosis was 6% in the whole population, but increased up to 25% among those subjects with ABI ≤0.9 regardless of REGICOR score. Using REGICOR ≥10%, the likelihood ratio (LR) for the detection of SCCA was 1.8, while using ABI ≤0.90 the LR was 6.0. After multivariate regression analysis, low ABI was independently associated with SCCA whereas REGICOR score was not. Less than 40% of subjects with SCCA were taking antiplatelet drugs or statins at the moment of diagnosis. Conclusion: ABI emerged as a useful and simple tool in identifying asymptomatic SCCA in our population. This finding may be important for improving stroke primary prevention strategies. © 2014 Elsevier Ireland Ltd.
Original languageEnglish
Pages (from-to)72-75
Issue number1
Publication statusPublished - 1 Mar 2014


  • Carotid stenosis
  • Intracranial stenosis
  • Primary prevention
  • Subclinical atherosclerosis


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