Blood pressure variability and short-term outcomes after mechanical thrombectomy in patients with acute ischemic stroke
Copyright © 2023 Elsevier Inc. All rights reserved..
OBJECTIVES: There is limited data evaluating effects of post-mechanical thrombectomy (MT) blood pressure (BP) control on short-term clinical outcomes in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). We aim to investigate the association of BP variations, after MT, with stroke early outcomes.
MATERIALS AND METHODS: A retrospective study was conducted on AIS patients with LVO undergoing MT at a tertiary center over 3.5 years. Hourly BP data was recorded within the first 24- and 48-hours post-MT. BP variability was expressed as the interquartile range (IQR) of BP distribution. Short-term favorable outcome was defined as modified Rankin scale (mRS) 0-3, discharge to home or inpatient rehabilitation facility (IRF).
RESULTS: Of the 95 enrolled subjects, 37(38.9%) had favorable outcomes at discharge and 8 (8.4%) died. After adjustment for confounders, an increase in IQR of systolic blood pressure (SBP) within the first 24 hours after MT revealed a significant inverse association with favorable outcomes (OR 0.43, 95% CI [0.19, 0.96], p = 0.039). Increased median MAP within the first 24 hours after MT correlated with favorable outcomes (OR 1.75, 95% CI [1.09, 2.83], p = 0.021). Subgroup analysis redemonstrated significant inverse association between increased SBP IQR and favorable outcomes (OR 0.48, 95% CI [0.21, 0.97], p = 0.042) among patients with successful revascularization.
CONCLUSIONS: Post-MT high SBP variability was associated with worse short-term outcomes in AIS patients with LVO regardless of recanalization status. MAP values may be used as indicators for functional prognosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 32(2023), 8 vom: 01. Aug., Seite 107197 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhou, Jiping [VerfasserIn] |
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| Links: |
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| Themen: |
Blood pressure |
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| Anmerkungen: |
Date Completed 15.08.2023 Date Revised 15.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jstrokecerebrovasdis.2023.107197 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357698290 |
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| 245 | 1 | 0 | |a Blood pressure variability and short-term outcomes after mechanical thrombectomy in patients with acute ischemic stroke |
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| 500 | |a Date Completed 15.08.2023 | ||
| 500 | |a Date Revised 15.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: There is limited data evaluating effects of post-mechanical thrombectomy (MT) blood pressure (BP) control on short-term clinical outcomes in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). We aim to investigate the association of BP variations, after MT, with stroke early outcomes | ||
| 520 | |a MATERIALS AND METHODS: A retrospective study was conducted on AIS patients with LVO undergoing MT at a tertiary center over 3.5 years. Hourly BP data was recorded within the first 24- and 48-hours post-MT. BP variability was expressed as the interquartile range (IQR) of BP distribution. Short-term favorable outcome was defined as modified Rankin scale (mRS) 0-3, discharge to home or inpatient rehabilitation facility (IRF) | ||
| 520 | |a RESULTS: Of the 95 enrolled subjects, 37(38.9%) had favorable outcomes at discharge and 8 (8.4%) died. After adjustment for confounders, an increase in IQR of systolic blood pressure (SBP) within the first 24 hours after MT revealed a significant inverse association with favorable outcomes (OR 0.43, 95% CI [0.19, 0.96], p = 0.039). Increased median MAP within the first 24 hours after MT correlated with favorable outcomes (OR 1.75, 95% CI [1.09, 2.83], p = 0.021). Subgroup analysis redemonstrated significant inverse association between increased SBP IQR and favorable outcomes (OR 0.48, 95% CI [0.21, 0.97], p = 0.042) among patients with successful revascularization | ||
| 520 | |a CONCLUSIONS: Post-MT high SBP variability was associated with worse short-term outcomes in AIS patients with LVO regardless of recanalization status. MAP values may be used as indicators for functional prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood pressure | |
| 650 | 4 | |a Ischemic stroke | |
| 650 | 4 | |a Mechanical thrombectomy | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Variability | |
| 700 | 1 | |a Samara, Heba |e verfasserin |4 aut | |
| 700 | 1 | |a Ebrahim, Ali |e verfasserin |4 aut | |
| 700 | 1 | |a Kinariwala, Jay |e verfasserin |4 aut | |
| 700 | 1 | |a Mohamed, Wazim |e verfasserin |4 aut | |
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