Aged ; Ankle Brachial Index ; Blood Flow Velocity/physiology* ; Brachial Artery/physiopathology* ; Brain Ischemia/drug therapy ; Brain Ischemia/physiopathology* ; Female ; Fibrinolytic Agents/therapeutic use ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Pulse Wave Analysis* ; Retrospective Studies ; Stroke/drug therapy ; Stroke/physiopathology* ; Tissue Plasminogen Activator/therapeutic use ; Treatment Outcome
Keywords
prognosis ; pulse wave analysis ; stroke
Abstract
BACKGROUND AND PURPOSE: We investigated whether the brachial-ankle pulse wave velocity (baPWV) has prognostic value for predicting functional outcome after acute cerebral infarction and whether the prognostic value differs between stroke subtypes.
METHODS: We included 1091 consecutive patients with first-ever acute cerebral infarction who underwent baPWV measurements. Stroke subtypes were classified using the Trial of Org 10172 in Acute Stroke Treatment classification. Poor functional outcomes were defined as modified Rankin Scale score >2 at 3 months after stroke onset.
RESULTS: We noted that 181 (16.59%) patients had a poor functional outcome. In multivariate logistic regression, patients in the highest tertile of baPWV (>22.25 m/s) were found to be at increased risk for poor functional outcome (adjusted odds ratio, 1.88; 95% confidence interval, 1.06-3.40) compared with those in the lowest tertile (<17.55 m/s). No significant interaction between baPWV and stroke subtype was noted. Receiver operating characteristic curve analysis indicated that the addition of baPWV to the prediction model significantly improved the discrimination ability for poor functional outcome.
CONCLUSIONS: baPWV has an independent prognostic value for predicting functional outcome after acute cerebral infarction. The prognostic value did not differ according to the stroke subtype.