@article{3105185,
    title = "Association of Blood Pressure with Outcomes in Acute Stroke Thrombectomy",
    author = "Malhotra, K. and Goyal, N. and Katsanos, A.H. and Filippatou, A. and Mistry, E.A. and Khatri, P. and Anadani, M. and Spiotta, A.M. and Sandset, E.C. and Sarraj, A. and Magoufis, G. and Krogias, C. and Tönges, L. and Safouris, A. and Elijovich, L. and Goyal, M. and Arthur, A. and Alexandrov, A.V. and Tsivgoulis, G.",
    journal = "JOURNAL OF HYPERTENSION",
    year = "2020",
    pages = "730-739",
    publisher = "Lippincott Williams and Wilkins",
    issn = "-",
    doi = "10.1161/HYPERTENSIONAHA.119.14230",
    keywords = "blood pressure;  brain ischemia;  convalescence;  follow up;  hemodynamics;  human;  meta analysis;  observational study;  physiology;  postoperative complication;  randomized controlled trial (topic);  survival analysis;  thrombectomy;  treatment outcome, Blood Pressure;  Follow-Up Studies;  Hemodynamics;  Humans;  Ischemic Stroke;  Observational Studies as Topic;  Postoperative Complications;  Randomized Controlled Trials as Topic;  Recovery of Function;  Survival Analysis;  Thrombectomy;  Treatment Outcome",
    abstract = "Limited data exist evaluating the effect of blood pressure (BP) on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with mechanical thrombectomy (MT). We sought to evaluate the association of BP levels on clinical outcomes among patients with acute ischemic stroke with large vessel occlusion treated with MT. Studies were identified that reported the association of systolic BP (SBP) or diastolic BP levels before, during, or after MT on the outcomes of patients with acute ischemic stroke treated with MT. Unadjusted and adjusted analyses of studies reporting odds ratios (ORadj) per 10 mm Hg BP increment were performed. Our analysis included 25 studies comprising 6474 patients. Higher pre-MT mean SBP (P=0.008) and post-MT maximum SBP (P=0.009) levels were observed in patients who died within 3 months. Patients with 3-month functional independence were noted to have lower pre-MT (P<0.001) and post-MT maximum SBP levels (P<0.001). In adjusted analyses, increasing post-MT maximum SBP and diastolic BP levels were associated with 3-month mortality (ORadj, 1.19 [95% CI,1.00-1.43]; I2=78%, P value for Cochran Q test: 0.001) and symptomatic intracranial hemorrhage (ORadj, 1.65 [95% CI, 1.11-2.44]; I2=0%, P value for Cochran Q test: 0.80), respectively. Increasing pre- and post-MT mean SBP levels were associated with lower odds of 3-month functional independence (ORadj, 0.86 [95% CI, 0.77-0.96]; I2=18%, P value for Cochran Q test: 0.30) and (ORadj, 0.80 [95% CI, 0.72-0.89]; I2=0%, P value for Cochran Q test: 0.51), respectively. In conclusion, elevated BP levels before and after MT are associated with adverse outcomes among patients with acute ischemic stroke with large vessel occlusion. © 2020 Lippincott Williams and Wilkins. All rights reserved."
}