ABSTRACT NUMBER: ESOC2026A94 LONG-TERM CLINICAL IMPACT OF ARTERIAL STIFFNESS IN PATIENTS WITH LACUNAR STROKE

Abstract Background and aims Arterial stiffness has been proposed as a prognostic marker in cerebral small vessel disease (SVD). We aimed to evaluate the association between pulse wave velocity (PWV) and long-term clinical outcomes after lacunar stroke. Methods We included consecutive patients admitted with lacunar stroke between November 2017 and July 2019. Electronic medical records were reviewed in September 2025 to identify clinical events, including recurrent stroke, ischemic heart disease, or death from any cause (composite endpoint). Clinical, hemodynamic and neuroimaging variables (SVD score) were analyzed. Comparisons were performed using Wilcoxon and Fisher’s tests, and independent predictors were identified by logistic regression and Cox survival analysis. Results Ninety-four patients were included (mean age 69 ± 11 years; 69% male), mean follow-up 5.8 years. Twenty-one (22%) experienced the composite endpoint. These patients were older, with higher 24-h PWV and higher SVD score. In multivariable logistic regression, 24-h PWV (OR 4.75, 95% CI 1.42–19.15; p = 0.017) and SVD score (OR 1.66, 95% CI 1.01–2.90; p = 0.055) were associated with the endpoint. In Cox analysis, both remained independent predictors: PWV (HR 2.43, 95% CI 1.09–5.45; p = 0.031) and SVD score (HR 1.57, 95% CI 1.05–2.36; p = 0.028). Conclusions In patients with lacunar stroke, increased arterial stiffness (higher PWV) and greater small vessel disease burden are independently associated with long-term risk of vascular events or death. PWV may represent a useful prognostic biomarker in small vessel disease follow-up. Conflict of interest Manuel Gomez-Choco: nothing to disclosure Sonia Maria García-Sánchez: nothing to disclosure Carla Avellaneda-Gomez: nothing to disclosure Sandra Boned: nothing to disclosure Juan Jose Mengual: nothing to disclosure Carmen Montalvo: nothing to disclosure Merce Lleixa: nothing to disclosure Pere Blanch: nothing to disclosure Pere Castellanos: nothing to disclosure Pedro Armario: nothing to disclosure