ArticleStroke (Hoboken, N.J.)2025
Association Between Estimated Pulse Wave Velocity and Endovascular Thrombectomy Outcome: A Secondary Analysis of the OPTIMAL-BP Trial.
Article in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The link between arterial stiffness, measured by estimated pulse wave velocity (ePWV), and outcomes following endovascular thrombectomy (EVT) has not been tested. This study aimed to determine whether ePWV predicts post-EVT outcome in patients with acute ischemic stroke. Methods: This was a secondary analysis of the OPTIMAL-BP (Outcome in Patients Treated With Intraarterial Thrombectomy-Optimal Blood Pressure Control) trial, which enrolled 302 EVT patients from 19 stroke centers in South Korea between June 18, 2020 and November 28, 2022. The ePWV was calculated using a regression equation based on age and mean blood pressure (BP) at trial enrollment: ePWV = 9.587-0.402×age+4.560×10 Results: Among 302 patients (mean age 73.1±11.5 years, 59.6% men), higher ePWV was independently associated with a lower likelihood of functional independence at 3 months (adjusted odds ratio, 0.80 [95% CI, 0.68-0.94] per 1 m/s increase; adjusted odds ratio, 0.36 [95% CI, 0.14-0.95] for the fourth quartile). A reduction in ePWV at 24 hours after EVT increased the likelihood of functional independence at 3 months in patients receiving conventional BP management (adjusted odds ratio, 3.41 [95% CI, 1.02‒11.38]) but not in those receiving intensive BP management. Incorporating ePWV significantly improved prognostic model performance, with net reclassification improvement of 0.28 (95% CI, 0.06-0.50) and integrated discrimination improvement of 0.02 (95% CI, 0.003-0.04). Conclusion: The ePWV independently predicts functional independence after EVT, suggesting its potential as a practical prognostic indicator using age and baseline BP.
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