title: Increased pulse wave velocity in patients with acute lacunar infarction doubled the risk of future ischemic stroke.
abstract: The aim of this study was to determine whether pulse wave velocity (PWV), a marker of vascular endothelial impairment and arteriosclerosis, predicts future ischemic stroke in patients who developed acute lacunar infarction. Patients with a first-ever ischemic stroke due to acute lacunar infarction were enrolled in this study. An oscillometric device (Form PWV/ABI; Omron Colin, Tokyo, Japan) was used to measure brachial-ankle PWV 1 week after stroke onset. Patients were followed for at least 5 years. The main end point of the study was recurrent ischemic stroke. Event-free survival was analyzed using Kaplan-Meier plots and log-rank tests. The risk of recurrent ischemic stroke was estimated using the Cox proportional-hazards model. Of the 156 patients (61% male, mean age: 69.2±11.3 years) assessed in this study, 29 developed recurrent ischemic stroke. The median brachial-ankle PWV value was 20.4 m s-1. Patients with high PWV values had a greater risk of recurrent ischemic stroke than patients with low PWV values (28% vs. 15%, P=0.08). Kaplan-Meier curve analysis showed that patients with high PWV values had a less favorable (that is, free of recurrent ischemic stroke) survival time (P=0.015). A multivariate Cox proportional-hazards model identified high PWV as an independent predictor of recurrent ischemic stroke after adjusting for age, sex and blood pressure (hazard ratio 2.35, 95% confidence interval, 1.02-5.70, P=0.044). In patients with acute lacunar infarction, a high PWV predicts a twofold greater risk of future ischemic stroke, independent of patient age, sex and blood pressure levels.
authors.affiliation: Department of Neurology, Hyogo Brain and Heart Center at Himeji, Hyogo, Japan.|Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Aichi, Japan.|Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
authors.affiliation: Division of Biostatistics, Center for Clinical Research, Aichi Medical University, Aichi, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Murotani
authors.affiliation: Department of Neurology, Hyogo Brain and Heart Center at Himeji, Hyogo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Department of Neurology, Hyogo Brain and Heart Center at Himeji, Hyogo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Uehara
authors.affiliation: Department of Neurology, Hyogo Brain and Heart Center at Himeji, Hyogo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kita
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002545:Brain Ischemia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012008:Recurrence; D012307:Risk Factors; D059409:Stroke, Lacunar / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*