Increased pulse wave velocity in patients with acute lacunar infarction doubled the risk of future ischemic stroke

Area of Science:

• Cardiology
• Neurology
• Vascular Medicine

Background:

• Arteriosclerosis and vascular endothelial impairment are significant risk factors for ischemic stroke.
• Pulse wave velocity (PWV) is a non-invasive marker reflecting arterial stiffness and vascular health.
• Predicting recurrent ischemic stroke in patients with acute lacunar infarction is crucial for secondary prevention.

Purpose of the Study:

• To investigate whether brachial-ankle pulse wave velocity (baPWV) predicts future ischemic stroke events.
• To assess the association between high baPWV and the risk of recurrent ischemic stroke in patients with a first-ever lacunar infarction.

Main Methods:

• A cohort of 156 patients with first-ever acute lacunar infarction was enrolled.
• Brachial-ankle pulse wave velocity (baPWV) was measured using an oscillometric device one week post-stroke.
• Patients were followed for at least 5 years to record recurrent ischemic stroke events.

Main Results:

• A total of 29 patients experienced recurrent ischemic stroke during the follow-up period.
• Higher baPWV values were associated with an increased risk of recurrent ischemic stroke (28% vs. 15%).
• Multivariate analysis identified high baPWV as an independent predictor (HR 2.35, P=0.044) of recurrent ischemic stroke, irrespective of age, sex, and blood pressure.

Conclusions:

• Elevated brachial-ankle pulse wave velocity is a significant independent predictor of recurrent ischemic stroke in patients with acute lacunar infarction.
• PWV measurement can aid in risk stratification and guide secondary prevention strategies for stroke patients.
• These findings underscore the importance of assessing arterial stiffness in managing patients post-lacunar infarction.