Arterial stiffness, pressure wave reflections predict survival, recurrence in stroke patients

Aortic stiffness, pressure wave reflections (PWRs), and their combined incremental value play pivotal roles in predicting long-term survival, morbidity, and functional disability in patients with acute stroke, suggest the results of a study.

“Stroke patients’ management might be improved by addressing the role of aortic stiffness (carotid-femoral pulse wave velocity [cfPWV]) and PWRs (augmentation index: AIx) in their pathogenesis and outcome,” said the researchers.

Using data from the Athens Stroke Registry, a group of researchers tested the hypothesis that cfPWV and Aix, separately and combined, could predict long-term outcomes (ie, all-cause mortality, incidence of cardiovascular events, stroke recurrence and disability defined by modified Ranking Scale [mRS] ≥3) in patients with acute stroke.

A total of 552 patients (mean age 66.1 years, 70 percent men) provided data for analysis, with a mean follow-up of 68.4 months. Of these, 13.4 percent died from any cause, 21.2 percent experienced cardiovascular events, 14.1 percent had stroke recurrences, and 20.1 percent presented with poor mRS.

High aortic stiffness (cfPWV >13 m/s) independently predicted all-cause mortality and cardiovascular events, but not stroke recurrence and poor functional outcome, among patients with acute stroke. On the other hand, neither high nor low PWRs showed any prognostic value when assessed separately from aortic stiffness.

Notably, patients with both high aortic stiffness and low PWRs (Aix <22 percent) had a nearly twofold increased risk of all-cause mortality, cardiovascular events, stroke recurrence, and poor functional outcome after adjusting for multiple confounders.