ARTERIAL STIFFNESS GRADIENT PREDICTS INDEPENDENTLY FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE

Abstract

Objective: Arterial stiffness is a strong predictor of morbidity in various clinical conditions, including ischemic stroke. However, the prognostic significance of the newly emerged aortic–brachial arterial stiffness gradient, defined as carotid–femoral/radial -carotid pulse wave velocity (PWV ratio) for functional outcome in ischemic stroke remains unknown. Design and method: We enrolled 144 patients (114 males, age 63.1 ± 12.4 years, mean ± SD) with acute ischemic stroke (NIHSS score at admission 6.6 ± 5.3 points). Carotid-femoral pulse wave velocity (PWV), radial –carotid PWV and peripheral blood pressure (BP) were measured (SphygmoCorâ) within several (6 ± 2) days after stroke onset. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale (mRS) with an mRS score of 3 to 6 (dependency or death) considered as a poor outcome. Results: PWV ratio was higher in patients with a poor stroke outcome than in patients of the reference group (1.34 ± 0.58 vs 1.17 ± 0.30; p = 0.017). In a multivariate analysis, the predictive value of PWV ratio remained significant (OR, 3.62; 95% CI, 1.04–12.75; p = 0.044) after adjustment for covariates. In contrast, CF PWV had no significant predictive value for stroke poor outcome. Conclusions: We found that the higher PWV ratio in patients in the subacute phase of ischemic stroke is independently associated with a poor outcome. This PWV index might be useful in clinical practice, including therapeutic decisions, but needs broader studies in patient populations of stroke subtypes.