[PP.37.11] PROGNOSTIC IMPACT OF ARTERIAL STIFFNESS ON MORTALITY IN BLACK AFRICAN PATIENTS WITH ACUTE STROKE

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Abstract

Objective:

Increased aortic stiffness(AS), is a determinant of stroke mortality, especially in Caucasian patients. Whether aortic pulse wave velocty (PWV), a gold standard measure of AS, and augmentation index (AI), a surrogate measure of AS are related to mortality in acute stroke in black African patients have been poorly investigated. This study assessed the pronostic impact of PWV and AI on mortality in Cameroonian patients with acute stroke.

Design and method:

We prospectively enrolled 138 patients who were admitted with acute stroke in the two public hospitals of Douala, 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), AI corrected for HR (AIx) and aortic PWV were measured (SphygmoCor) at one week or lesser following stroke onset. The outcome was evaluated at discharge with in-hospital mortality and post-charge with community mortality whitin 30 days following stroke onset.

Results:

BP were comparable between died and survied groups (p > 0.05). PWV was faster in patients with NIHSS score over 14 than in those with NIHSS score of 14 or lesser: 10.7 ± 2.3 m/s vs 9. 7 ± 1.9 m/s, P = 0.012. PWV and AIx were greater in died than survived group: 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, respectivement. PWV increased markedly with aging to a larger extend in patients who died as compared to those who survived (P = 0,014). Aged-adjusted PWVgreater or equal to 10 m/s was strongly associated with early and high mortality rate compared to participants with PWV < 10 m/s (P = 0,006). AIx increased significantly with aging to comparable extend in both two groups (P = 0.5). Multivariate regression analysis reavealed PWV greater or equal to 10 m/s, diabetes mellitus, Glasgow score of 8 or lesser and NIHSS score over 14, as independant predictors of mortality during acute stroke in this study population.

Conclusions:

PWV is strongly associated with early and high mortality rate in Cameroonian patients with acute stroke, independenly of other know pronostic factors.

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