Περίληψη:
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.
Συγγραφείς:
Katsanos, Aristeidis H.
Malhotra, Konark
Ahmed, Niaz and
Seitidis, Georgios
Mistry, Eva A.
Mavridis, Dimitris
Kim,
Joon-Tae
Veroniki, Areti Angeliki
Maier, Ilko
Matusevicius,
Marius
Khatri, Pooja
Anadani, Mohammad
Goyal, Nitin and
Arthur, Adam S.
Sarraj, Amrou
Yaghi, Shadi
Shoamanesh,
Ashkan
Catanese, Luciana
Kantzanou, Maria
Psaltopoulou,
Theodora
Rentzos, Alexandros
Psychogios, Marios
Van Adel,
Brian
Spiotta, Alejandro M.
Sandset, Else Charlotte
de
Havenon, Adam
Alexandrov, Andrei V.
Petersen, Nils H. and
Tsivgoulis, Georgios
