The association between cerebral atherosclerosis and arterial stiffness in acute ischemic stroke

Abstract

Objective: Arterial stiffness is associated with cardiovascular risk factors and atherosclerosis. Measurement of pulse wave velocity (PWV) is one of the most representative and noninvasive techniques for assessing arterial stiffness. We investigated the association of cerebral atherosclerosis with brachial-ankle PWV (baPWV) in acute ischemic stroke patients. If present, we sought to determine whether the relationship differed between atherosclerosis in the intracranial artery and atherosclerosis in the extracranial artery.

Methods: We included 801 patients with acute ischemic stroke who had undergone angiographic study and baPWV measurement between January 2007 and May 2010. Patients with cerebral artery atherosclerosis were categorized into those with intracranial atherosclerosis, those with extracranial atherosclerosis and those with both intracranial and extracranial atherosclerosis. We determined factors that were associated with baPWV.

Results: Univariate and multivariate analyses showed that high baPWV was significantly associated with older age, lower body mass index, higher brachial systolic pressure, and diabetes mellitus. Increased baPWV was associated with the presence of atherosclerosis (≥ 50% stenosis) in the intracranial cerebral artery as well as in both the intracranial and extracranial arteries, but not with atherosclerosis in the extracranial cerebral artery. The burden of intracranial cerebral atherosclerosis, which was assessed based on the number of arteries with atherosclerosis, was also closely associated with baPWV.

Conclusion: Arterial stiffness was associated with the presence and burden of intracranial cerebral atherosclerosis in stroke patients, but was not associated with the extracranial cerebral atherosclerosis. These findings suggest a potential pathophysiological association between increased arterial stiffness and intracranial cerebral atherosclerosis.