LBPS 03-13 PROGNOSTIC IMPACT OF EARLY VASCULAR AGING ON MORTALITY IN ACUTE STROKE IN BLACK AFRICAN ANCESTRY

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Abstract

Objective:

Evaluate the prognostic impact of PWV and AIx, both biomarkers of EVA on mortality in Cameroonian patients with acute stroke.

Design and Method:

We prospectively enrolled 138 patients admitted with acute stroke in the two main public teaching hospitals of Douala town, Cameroon (53.9 % females, mean age: 64 ± 13 years). The severity of stroke was assessed on admission with the National Institutes of Health Stroke Scale (NIHSS) score. Heart rate (HR), central blood pressures (BP), AI corrected for HR (AIx) and aortic PWV were measured (SphygmoCor) ≤ one week following stroke onset. The outcome was evaluated at discharge with in-hospital mortality and after discharge with community mortality within 30 days following stroke onset.

Results:

BP did not differ between died vs. survived patients (p > 0.05). PWV was faster in patients with NIHSS score >14 as compared to those with NIHSS score ≤ 14 on admission: 10.7 ± 2.3 m/s vs 9.7 ± 1.9 m/s, P = 0.012. PWV and AIx were greater in died vs. survived patients: 10.9 ± 2.2 m/s vs 9.7 ± 1.9 m/s P = 0.0022 and 31 ± 12% vs 26 ± 12% P = 0.023, respectively. PWV increased markedly with aging in patients who died as compared to those who survived (P = 0,014). Importantly, aged-adjusted PWV≥10 m/s was strongly associated with early and high mortality rate as compared to participants with PWV<10 m/s (P = 0,006). AIx increased did not increase significantly with aging in both two groups (P > 0.05). Multivariate regression analysis revealed that PWV≥ 10 m/s, diabetes mellitus, Glasgow score≤ 8 and NIHSSscore >14, were independent predictors of mortality during acute stroke in our study population.

Conclusions:

Increased aortic PWV is associated with early and high mortality rate in black Cameroonian patients with acute stroke; independently of other known prognostic factors. EVA may be a potential underlying mechanism explaining severe burden of stroke in black African ancestry.

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