Stroke: Vascular and Interventional Neurology (May 2025)
Association Between Estimated Pulse Wave Velocity and Endovascular Thrombectomy Outcome: A Secondary Analysis of the OPTIMAL‐BP Trial
- Minho Han,
- Haram Joo,
- Hyungwoo Lee,
- JoonNyung Heo,
- Jae Wook Jung,
- Young Dae Kim,
- Eunjeong Park,
- Kwang Hyun Kim,
- Jaeseob Yun,
- Jin Kyo Choi,
- Il Hyung Lee,
- Byung Moon Kim,
- Dong Joon Kim,
- Na Young Shin,
- Bang‐Hoon Cho,
- Seong Hwan Ahn,
- Hyungjong Park,
- Sung‐Il Sohn,
- Jeong‐Ho Hong,
- Tae‐Jin Song,
- Yoonkyung Chang,
- Gyu Sik Kim,
- Kwon‐Duk Seo,
- Kijeong Lee,
- Jun Young Chang,
- Jung Hwa Seo,
- Sukyoon Lee,
- Jang‐Hyun Baek,
- Han‐Jin Cho,
- Dong Hoon Shin,
- Jinkwon Kim,
- Joonsang Yoo,
- Minyoul Baik,
- Kyung‐Yul Lee,
- Yo Han Jung,
- Yang‐Ha Hwang,
- Chi Kyung Kim,
- Jae Guk Kim,
- Chan Joo Lee,
- Sungha Park,
- Soyoung Jeon,
- Hye Sun Lee,
- Sun U Kwon,
- Oh Young Bang,
- Ji Hoe Heo,
- Hyo Suk Nam
Affiliations
- Minho Han
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Haram Joo
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Hyungwoo Lee
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- JoonNyung Heo
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Jae Wook Jung
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Young Dae Kim
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Eunjeong Park
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Kwang Hyun Kim
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Jaeseob Yun
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Jin Kyo Choi
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Il Hyung Lee
- Department of Neurology Kyung Hee University Hospital at Gangdong Seoul South Korea
- Byung Moon Kim
- Department of Radiology Yonsei University College of Medicine Seoul South Korea
- Dong Joon Kim
- Department of Radiology Yonsei University College of Medicine Seoul South Korea
- Na Young Shin
- Department of Radiology Yonsei University College of Medicine Seoul South Korea
- Bang‐Hoon Cho
- Department of Neurology Korea University Anam Hospital and College of Medicine Seoul South Korea
- Seong Hwan Ahn
- Department of Neurology Chosun University School of Medicine Gwangju South Korea
- Hyungjong Park
- Department of Neurology Brain Research Institute Keimyung University School of Medicine Daegu South Korea
- Sung‐Il Sohn
- Department of Neurology Brain Research Institute Keimyung University School of Medicine Daegu South Korea
- Jeong‐Ho Hong
- Department of Neurology Brain Research Institute Keimyung University School of Medicine Daegu South Korea
- Tae‐Jin Song
- Department of Neurology College of Medicine Seoul Hospital Ewha Woman's University Seoul South Korea
- Yoonkyung Chang
- Department of Neurology Mokdong Hospital Ewha Womans University College of Medicine Seoul South Korea
- Gyu Sik Kim
- National Health Insurance Service Ilsan Hospital Goyang South Korea
- Kwon‐Duk Seo
- National Health Insurance Service Ilsan Hospital Goyang South Korea
- Kijeong Lee
- National Health Insurance Service Ilsan Hospital Goyang South Korea
- Jun Young Chang
- Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
- Jung Hwa Seo
- Department of Neurology Dong‐A University Hospital Busan South Korea
- Sukyoon Lee
- Department of Neurology Busan Paik Hospital Inje University College of Medicine Busan South Korea
- Jang‐Hyun Baek
- Department of Neurology Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul South Korea
- Han‐Jin Cho
- Department of Neurology Pusan National University School of Medicine Busan South Korea
- Dong Hoon Shin
- Department of Neurology Gachon University Gil Medical Center Incheon South Korea
- Jinkwon Kim
- Department of Neurology Yongin Severance Hospital Yonsei University College of Medicine Yongin South Korea
- Joonsang Yoo
- Department of Neurology Yongin Severance Hospital Yonsei University College of Medicine Yongin South Korea
- Minyoul Baik
- Department of Neurology Yongin Severance Hospital Yonsei University College of Medicine Yongin South Korea
- Kyung‐Yul Lee
- Department of Neurology Gangnam Severance Hospital Yonsei University College of Medicine Seoul South Korea
- Yo Han Jung
- Department of Neurology Gangnam Severance Hospital Yonsei University College of Medicine Seoul South Korea
- Yang‐Ha Hwang
- Department of Neurology Kyungpook National University Hospital School of Medicine Kyungpook National University Daegu South Korea
- Chi Kyung Kim
- Department of Neurology Korea University Guro Hospital and College of Medicine Seoul South Korea
- Jae Guk Kim
- Department of Neurology Daejeon Eulji Medical Center Eulji University School of Medicine Daejon South Korea
- Chan Joo Lee
- Department of Health Promotion Severance Hospital Yonsei University College of Medicine Seoul Republic of Korea
- Sungha Park
- Department of Health Promotion Severance Hospital Yonsei University College of Medicine Seoul Republic of Korea
- Soyoung Jeon
- Department of Research Affairs Biostatistics Collaboration Unit Yonsei University College of Medicine Seoul South Korea
- Hye Sun Lee
- Department of Research Affairs Biostatistics Collaboration Unit Yonsei University College of Medicine Seoul South Korea
- Sun U Kwon
- Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
- Oh Young Bang
- Department of Neurology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea
- Ji Hoe Heo
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- Hyo Suk Nam
- Department of Neurology Yonsei University College of Medicine Seoul South Korea
- DOI
- https://doi.org/10.1161/svin.124.001678
- Journal volume & issue
-
Vol. 5,
no. 3
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+4.560×10−3×age2−2.621×10−5×age2×mean BP+3.176×10−3×age×mean BP−1.832×10−2×mean BP. The primary outcome was functional independence at 3 months, defined as a modified Rankin Scale score of 0–2. Logistic, ordinal, or linear regression analyses were employed to estimate adjusted odds ratios with 95% CIs for outcomes per 1 m/s or quartile ePWV increase. 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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