TY - JOUR
TI - Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients
With Acute Ischemic Stroke An Individual Patient Data Meta-analysis
AU - Katsanos, Aristeidis H.
AU - Malhotra, Konark
AU - Ahmed, Niaz and
AU - Seitidis, Georgios
AU - Mistry, Eva A.
AU - Mavridis, Dimitris
AU - Kim,
AU - Joon-Tae
AU - Veroniki, Areti Angeliki
AU - Maier, Ilko
AU - Matusevicius,
AU - Marius
AU - Khatri, Pooja
AU - Anadani, Mohammad
AU - Goyal, Nitin and
AU - Arthur, Adam S.
AU - Sarraj, Amrou
AU - Yaghi, Shadi
AU - Shoamanesh,
AU - Ashkan
AU - Catanese, Luciana
AU - Kantzanou, Maria
AU - Psaltopoulou,
AU - Theodora
AU - Rentzos, Alexandros
AU - Psychogios, Marios
AU - Van Adel,
AU - Brian
AU - Spiotta, Alejandro M.
AU - Sandset, Else Charlotte
AU - de
AU - Havenon, Adam
AU - Alexandrov, Andrei V.
AU - Petersen, Nils H. and
AU - Tsivgoulis, Georgios
JO - Functional Neurology
PY - 2022
VL - 98
TODO - 3
SP - E291-E301
PB - Lippincott, Williams & Wilkins
SN - null
TODO - 10.1212/WNL.0000000000013049
TODO - null
TODO - Background and Objectives To explore the association between blood
pressure (BP) levels after endovascular thrombectomy (EVT) and the
clinical outcomes of patients with acute ischemic stroke (AIS) patients
with large vessel occlusion (LVO). Methods A study was eligible if it
enrolled patients with AIS >18 years of age with an LVO treated with
either successful or unsuccessful EVT and provided either individual or
mean 24-hour systolic BP values after the end of the EVT procedure.
Individual patient data from all studies were analyzed with a
generalized linear mixed-effects model. Results A total of 5,874
patients (mean age 69 +/- 14 years; 50% women; median NIH Stroke Scale
score on admission 16) from 7 published studies were included.
Increasing mean systolic BP levels per 10 mm Hg during the first 24
hours after the end of the EVT were associated with a lower odds of
functional improvement (unadjusted common odds ratio [OR] 0.82, 95%
confidence interval [CI] 0.80-0.85; adjusted common OR 0.88, 95% CI
0.84-0.93) and modified Rankin Scale score <= 2 (unadjusted OR 0.82,
95% CI 0.79-0.85; adjusted OR 0.87, 95% CI 0.82-0.93) and a higher
odds of all-cause mortality (unadjusted OR 1.18, 95% CI 1.13-1.24;
adjusted OR 1.15, 95% CI 1.06-1.23) at 3 months. Higher 24-hour mean
systolic BP levels were also associated with an increased likelihood of
early neurologic deterioration (unadjusted OR 1.14, 95% CI 1.07-1.21;
adjusted OR 1.14, 95% CI 1.03-1.24) and a higher odds of symptomatic
intracranial hemorrhage (unadjusted OR 1.20, 95% CI 1.09-1.29; adjusted
OR 1.20, 95% CI 1.03-1.38) after EVT. Discussion Increased mean
systolic BP levels in the first 24 hours after EVT are independently
associated with a higher odds of symptomatic intracranial hemorrhage,
early neurologic deterioration, 3-month mortality, and worse 3-month
functional outcomes.
ER -