Kentaro Ishizuka1, Takao Hoshino2, Satoru Shimizu3, Yuka Shirai2, Satoko Mizuno2, Sono Toi2, Kenji Maruyama2, Shinichiro Uchiyama4, Kazuo Kitagawa2. 1. Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. Electronic address: kishizuka@nij.twmu.ac.jp. 2. Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. 3. Medical Research Institute, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. 4. Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Clinical Research Center for Medicine, International University of Health and Welfare, Tokyo, Japan; Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan.
Abstract
BACKGROUND AND AIMS: Brachial-ankle pulse wave velocity (baPWV) is a good measure of arterial stiffness and is associated with risk of future vascular events. The present study aimed to examine whether baPWV can also predict 3-month functional outcome after stroke. METHODS: This hospital-based study included 327 consecutive patients with acute ischemic stroke and in whom baPWV was measured during hospitalization. We defined good and poor functional outcomes as a modified Rankin Scale score of <3 and ≥ 3 at 3 months, respectively, after initial stroke. RESULTS: Patients with poor outcomes were significantly older (73.1 versus 66.3 years, p < 0.001) and more likely to have extracranial carotid arterial stenosis (29.5% versus 13.1%, p < 0.001), atrial fibrillation (21.0% versus 11.3%, p = 0.020), history of coronary artery disease (20.0% versus 11.7%, p = 0.042), and high baPWV value (22.84 versus 19.48 m/s, p < 0.001). Irrespective of patients' age, sex, baseline risk factors, initial stroke severity, and stroke etiology, baPWV was consistently higher in patients with poor outcome than those with good outcome. Multivariate analysis revealed that baPWV >23.11 m/s, calculated from the receiver-operating characteristic curve, had an independent predictive value for poor functional outcome (odds ratio, 1.51; 95% confidence interval, 1.08-2.11; p = 0.016). CONCLUSIONS: BaPWV measured during the acute phase of stroke can independently predict 3-month functional prognosis. We suggest that baPWV should be performed as part of the early stroke work-up to identify patients suffering from severe stroke-related disability. Copyright Â
BACKGROUND AND AIMS: Brachial-ankle pulse wave velocity (baPWV) is a good measure of arterial stiffness and is associated with risk of future vascular events. The present study aimed to examine whether baPWV can also predict 3-month functional outcome after stroke. METHODS: This hospital-based study included 327 consecutive patients with acute ischemic stroke and in whom baPWV was measured during hospitalization. We defined good and poor functional outcomes as a modified Rankin Scale score of <3 and ≥ 3 at 3 months, respectively, after initial stroke. RESULTS:Patients with poor outcomes were significantly older (73.1 versus 66.3 years, p < 0.001) and more likely to have extracranial carotid arterial stenosis (29.5% versus 13.1%, p < 0.001), atrial fibrillation (21.0% versus 11.3%, p = 0.020), history of coronary artery disease (20.0% versus 11.7%, p = 0.042), and high baPWV value (22.84 versus 19.48 m/s, p < 0.001). Irrespective of patients' age, sex, baseline risk factors, initial stroke severity, and stroke etiology, baPWV was consistently higher in patients with poor outcome than those with good outcome. Multivariate analysis revealed that baPWV >23.11 m/s, calculated from the receiver-operating characteristic curve, had an independent predictive value for poor functional outcome (odds ratio, 1.51; 95% confidence interval, 1.08-2.11; p = 0.016). CONCLUSIONS:BaPWV measured during the acute phase of stroke can independently predict 3-month functional prognosis. We suggest that baPWV should be performed as part of the early stroke work-up to identify patients suffering from severe stroke-related disability. Copyright Â