Proposing arterial stiffness as an alternative way of assessing risk in transient ischaemic attack (TIA) patients

Background: The ABCD2 score is a clinical tool currently categorising transient ischaemic attack (TIA) patients as low or high risk. Arterial stiffness, a novel physiological parameter predicting future cardiovascular events, has not been explored in TIA populations. Methods: The following arterial stiffness parameters were measured in TIA patients aged >40 years: carotid-femoral pulse wave velocity (C-F PWV), carotid-radial pulse wave velocity (C-R PWV) using Complior (R) and central and peripheral blood pressure (BP) using Arteriograph (R). Nocturnal BP dipping profiles were measured using 24-h ambulatory blood pressure monitoring. TIA participants were age-and gender-matched with healthy subjects to compare arterial stiffness and BP profiles. Results: Twenty-four TIA patients, 50% male, of mean +/- SD age 70 +/- 10.1 years were recruited to the study. Mean +/- SD C-F PWV was 11.5 +/- 3.18 m/s and C-R PWV was 10.8 +/- 1.26 m/s. Published normative data for healthy age-and gender-matched subjects are C-F PWV 10.9 m/s and C-R PWV 10.1 m/s. Our TIA patients had higher central (130 mmHg) than peripheral BP (128 mmHg) compared with healthy subjects in whom central BP is 10-15 mmHg lower than peripheral BP. Thirty-eight percent of TIA patients lacked nocturnal dipping compared with 19% of healthy subjects. Conclusions: In our TIA cohort we found increased arterial stiffness measurements compared to healthy subjects.