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August 25, 2026Journal of Stroke and Cerebrovascular DiseasesOpen Access

Low pre-discharge RHI linked to ~82% greater odds of poor functional outcome after ischemic stroke.

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Why the study?

EndoPAT-derived reactive hyperemia index (RHI) assesses peripheral endothelial dysfunction, but its clinical value after acute ischemic stroke remains uncertain.

Is low peripheral endothelial function (RHI ≤1.67) associated with worse functional outcomes and clinical events in patients with acute ischemic stroke?

Population

357 acute ischemic stroke patients with valid RHI measurements

Comparison

Low RHI (≤1.67) vs normal RHI

Design

Retrospective analysis of a prospectively maintained single-center registry

Follow-up

3 months

Key result

Low pre-discharge reactive hyperemia index (≤1.67) was associated with poor discharge functional outcome after acute ischemic stroke (adjusted OR 1.82; 95% CI 1.04-3.18; P=0.036).

Authors

KKKyongyoung KimSJSeunguk JungECEun Bin Cho

Discussion

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Member takes

Overview

Low RHI may flag higher short-term risk after ischemic stroke; leaves open independent prognostic value beyond discharge.

Study Design

Type

Cohort (n=357)

Multicenter

No

Structured PICO

Is low peripheral endothelial function (RHI ≤1.67) associated with worse functional outcomes and clinical events in patients with acute ischemic stroke?

P
Population
357 patients with acute ischemic stroke followed through discharge and 3 months to evaluate the association of reactive hyperemia index with functional outcomes.
E
Exposure
Low reactive hyperemia index (RHI ≤1.67) measured by EndoPAT
C
Comparator
Normal reactive hyperemia index (RHI >1.67)
O
Outcome
Functional outcomes at discharge and 3 months, early neurological deterioration (END), 3-month clinical events, and incremental outcome predictionhard clinical

Main Result

Odds Ratio: 1.82 (95% CI 1.04–3.18)

Absolute Event Rate: 32.9% vs 25%

p-value: p=0.036

Low pre-discharge reactive hyperemia index is associated with poor functional outcome at discharge but lacks independent prognostic value for longer-term outcomes or clinical events after acute ischemic stroke.

Cite This Study

Kim et al. (2026) conducted a cohort in Acute ischemic stroke (n=357). Low reactive hyperemia index (RHI ≤1.67) vs. Normal reactive hyperemia index was evaluated on Poor discharge functional outcome (adjusted OR 1.82, 95% CI 1.04-3.18, p=0.036). Low pre-discharge reactive hyperemia index (≤1.67) was associated with poor discharge functional outcome after acute ischemic stroke (adjusted OR 1.82; 95% CI 1.04-3.18; P=0.036).

synapsesocial.com/papers/6aa946ccc924504423cdcd3chttps://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108734
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessment of peripheral vascular endothelial function in the ambulatory setting2007 · 148 citations
  2. 2Role of nitric oxide in the regulation of digital pulse volume amplitude in humans2006 · 437 citations
  3. 3Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.1993 · 12,466 citations
  4. 4Validation of Repeated Endothelial Function Measurements Using EndoPAT in Stroke2017 · 28 citations
  5. 5Endothelial Dysfunction of the Peripheral Vascular Bed in the Acute Phase after Ischemic Stroke2011 · 47 citations