Each 1 m/s increase in estimated pulse wave velocity was independently associated with poor functional outcomes (adjusted OR 1.277; 95% CI 1.072-1.521), with collateral status mediating this link.
Observational (n=285)
Is estimated pulse wave velocity associated with poor collaterals and functional outcome in patients with LVO stroke undergoing successful thrombectomy?
Elevated estimated pulse wave velocity is independently associated with poor collateral circulation and unfavorable functional outcomes in patients with LVO stroke after successful thrombectomy.
Effect estimate: adjusted OR 1.277 (95% CI 1.072-1.521)
Abstract Background and aims Estimated pulse wave velocity (ePWV), a surrogate marker of arterial stiffness derived from age and blood pressure, may influence stroke outcomes by affecting collateral circulation. This study investigated whether ePWV is associated with poor collaterals and if collateral status mediates the relationship between ePWV and functional outcome in patients with acute ischemic stroke due to large vessel occlusion (LVO) who underwent successful endovascular thrombectomy. Methods We analyzed 285 patients from the OPTIMAL-BP trial. Collateral status was assessed using the Tan scale and categorized as poor (grades 0–1) or good (grades 2–3). Functional outcome was defined by the modified Rankin Scale (mRS) at 3 months, dichotomized into poor (mRS 3–6) or good (mRS 0–2). Multivariable logistic regression and mediation analysis were performed. Results The mean age was 73.3±11.3 years; 40.4% were women. Poor collaterals and poor outcomes were observed in 32.6% and 53.0%, respectively. Higher ePWV was associated with older age, more severe stroke, and increased rates of poor collaterals and outcomes. Each 1 m/s increase in ePWV was independently associated with poor collaterals (adjusted odds ratio OR 1.308, 95% confidence interval CI 1.103–1.552) and poor outcomes (adjusted OR 1.277, 95% CI 1.072–1.521). Mediation analysis showed that collateral status mediated the ePWV-outcome relationship (indirect effect β=0.0266, 95% CI 0.0027–0.0581). Conclusions Elevated ePWV is independently associated with poor collateral circulation and unfavorable outcomes in LVO stroke. Collateral status mediates this link, suggesting a mechanistic pathway between arterial stiffness and stroke prognosis. Conflict of interest All authors: nothing to disclose
Han et al. (Fri,) conducted a observational in acute ischemic stroke due to large vessel occlusion (LVO) (n=285). Estimated pulse wave velocity (ePWV) was evaluated on poor functional outcome (mRS 3-6) at 3 months (adjusted OR 1.277, 95% CI 1.072-1.521). Each 1 m/s increase in estimated pulse wave velocity was independently associated with poor functional outcomes (adjusted OR 1.277; 95% CI 1.072-1.521), with collateral status mediating this link.