From the Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (J.K.); Department of Neurology, Ewha Womans University, Seoul, Korea (T.-J.S.); and Departments of Neurology (J.K., E.H.K., K.J.L., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L., C.M.N.), Yonsei University College of Medicine, Seoul, Korea.
Stroke. 2014 Aug;45(8):2305-10. doi: 10.1161/STROKEAHA.114.005576. Epub 2014 Jun 26.
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.
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.
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.
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.
本研究旨在探讨踝臂脉搏波速度（baPWV）对急性脑梗死患者功能结局的预测价值，以及其对不同卒中亚型的预后价值是否存在差异。
我们纳入了 1091 例首次发生急性脑梗死且接受 baPWV 测量的连续患者。采用组织型纤溶酶原激活剂急性卒中治疗试验分类标准对卒中亚型进行分类。功能结局不良定义为卒中发病后 3 个月改良 Rankin 量表评分>2 分。
我们发现 181 例（16.59%）患者存在功能结局不良。多变量逻辑回归分析显示，与 baPWV 最低三分位组（<17.55 m/s）相比，baPWV 最高三分位组（>22.25 m/s）患者发生功能结局不良的风险更高（调整优势比，1.88；95%置信区间，1.06-3.40）。baPWV 与卒中亚型之间未观察到显著交互作用。受试者工作特征曲线分析表明，baPWV 加入预测模型可显著提高对功能结局不良的预测能力。
baPWV 对急性脑梗死患者的功能结局具有独立的预后价值。其预后价值与卒中亚型无关。
