PERIPHERAL ARTERIAL STIFFNESS PREDICTS INDEPENDENTLY FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE

Abstract

Objective: Aortic stiffness is a strong predictor of morbidity in various clinical conditions, including ischemic stroke. However, the prognostic significance of the peripheral arterial stiffness, defined as radial -carotid pulse wave velocity - for functional outcome in ischemic stroke remains unknown. Design and method: We enrolled 189 patients (126 males, age 62.9±11.9 years, mean±SD) with acute ischemic stroke (NIHSS score at admission 6.4±5.1 points). Radial-carotid pulse wave velocity (CR PWV), peripheral blood pressure (BP) and heart rate (HR) were measured (SphygmoCor®) 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 0 to 1 considered as an excellent outcome. Results: In univariate analysis, age, severity of stroke, heart rate, previous stroke, predicted stroke functional outcome. By contrast, CR PWV had no significant predictive value for stroke outcome (8.91±1.66 vs 8.56±1.50 m/s; p=0.14). In a multivariate analysis, the predictive value of CR PWV was significantly associated with functional outcome (OR, 1.34; 95% CI, 1.77–1.01; p=0.04) after adjustment for covariates, with higher values of CR PWV being associated with better prognosis. Conclusions: We found that the CR PWV in patients in the subacute phase of ischemic stroke is associated with functional outcome independently of traditional neurologic and hemodynamic factors. This PWV index might be useful in clinical practice, including therapeutic decisions, but needs broader studies in patient populations of stroke subtypes.