Augmentation index as an early marker of in-hospital mortality in patients with acute ischemic stroke

Abstract

The aim of the present study was to estimate the relationship between arterial stiffness, expressed in terms of pulse wave velocity (PWV) and augmentation index (AIx), with stroke severity and outcome. We prospectively studied all patients who were admitted in our Department with acute ischemic stroke between January 2019 and July 2019 (n=94; 36 males, age 79.8 ± 9.1 years). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS) score and the Rankin score. In addition, AIx and PWV were recorded with the Mobil-O-Graph PWA. In-hospital mortality was 15.6% and mean duration of hospital stay was 6.3±4.7 days. Mean value of AIx was 30.6±12.3% and PWV was 12.8±2.1 m/sec. Patients who died during hospitalization had lower systolic blood pressure and higher white blood cells count, higher NIHSS score and Rankin score on admission while there was no difference between AIx and PWV.   Multivariate regression analysis, after adjustment for gender, duration of hospital stay, smoking status, history of previous stroke, arterial hypertension, dyslipidemia, NIHSS score and Rankin score, showed that AIx was related only with age (beta=0.49, p=0.03) and in-hospital mortality (beta= -0.43, p=0.04), while there was a trend for association with history of diabetes mellitus (beta= -0.36, p=0.08). No association was found between PWV and the examined variables.