Arterial stiffness as assessed by pulse wave velocity (PWV) improves the prediction of first-ever and recurring stroke and of stroke outcomes when measured in the days after stroke. Here, we investigated the longitudinal dynamics of PWV in the days after acute ischaemic stroke.

Monocentric, prospective cohort study nested within a clinical trial registry with repeated measurement assessment of PWV.

Comprehensive middle European stroke centre.

20 men and women that suffered stroke from November 2022 through August 2023.

Change in carotid-femoral PWV was investigated by recording PWV four times between 1.2 and 9.9 days after stroke using a Vicorder device. Haemodynamic and patient-, stroke- and care-related variables were investigated as potential modifiers of PWV trajectories.

Twenty patients aged 61.3±16.9 years (14 males) were included. There was a daily decline in PWV of –0.19 m/s (95% CI: –0.29 to –0.09; p0.05). Rank-order correlation between the earliest and latest PWV measurements was 0.87 (95% CI: 0.69 to 0.95; p

A marked decline in PWV during the first week after acute ischaemic stroke should be accounted for when interpreting PWV after recent stroke.

The STROKE-CARD Registry was registered at ClinicalTrials.gov (NCT04582825).