دورية أكاديمية
Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated with Outcome
| العنوان: | Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated with Outcome |
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| المؤلفون: | Samuels, Noor, Van De Graaf, Rob A., Van Den Berg, Carlijn A.L., Uniken Venema, Simone M., Bala, Kujtesa, Van Doormaal, Pieter Jan, Van Der Steen, Wouter, Witvoet, Elbert, Boiten, Jelis, Den Hertog, Heleen, Schonewille, Wouter J., Hofmeijer, Jeannette, Schreuder, Floris, Schreuder, Tobien A.H.C.M.L., Van Der Worp, H. Bart, Roos, Yvo B.W.E.M., Majoie, Charles B.L.M., Burke, James F., Van Es, Adriaan C.G.M., Van Der Lugt, Aad, Roozenbeek, Bob, Lingsma, Hester F., Dippel, Diederik W.J. |
| المصدر: | Samuels , N , Van De Graaf , R A , Van Den Berg , C A L , Uniken Venema , S M , Bala , K , Van Doormaal , P J , Van Der Steen , W , Witvoet , E , Boiten , J , Den Hertog , H , Schonewille , W J , Hofmeijer , J , Schreuder , F , Schreuder , T A H C M L , Van Der Worp , H B , Roos , Y B W E M , Majoie , C B L M , Burke .... |
| سنة النشر: | 2021 |
| الوصف: | Background and Purpose: Optimal blood pressure (BP) management in the acute phase of ischemic stroke remains an unresolved issue. It is uncertain whether guidelines for BP management during and after intravenous alteplase can be extrapolated to endovascular treatment (EVT) for stroke due to large artery occlusion in the anterior circulation. We evaluated the associations between systolic BP (SBP) in the first 6 hours following EVT and functional outcome as well as symptomatic intracranial hemorrhage. Methods: Patients of 8 MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry centers, with available data on SBP in the 6 hours following EVT, were analyzed. We evaluated maximum, minimum, and mean SBP. Study outcomes were functional outcome (modified Rankin Scale) at 90 days and symptomatic intracranial hemorrhage. We used multivariable ordinal and binary regression analysis to adjust for important prognostic factors and studied possible effect modification by successful reperfusion. Results: Post-EVT SBP data were available for 1161/1796 patients. Higher maximum SBP (per 10 mm Hg increments) was associated with worse functional outcome (adjusted common odds ratio, 0.93 [95% CI, 0.88-0.98]) and a higher rate of symptomatic intracranial hemorrhage (adjusted odds ratio, 1.17 [95% CI, 1.02-1.36]). The association between minimum SBP and functional outcome was nonlinear with an inflection point at 124 mm Hg. Minimum SBP lower and higher than the inflection point were associated with worse functional outcomes (adjusted common odds ratio, 0.85 per 10 mm Hg decrements [95% CI, 0.76-0.95] and adjusted common odds ratio, 0.81 per 10 mm Hg increments [95% CI, 0.71-0.92]). No association between mean SBP and functional outcome was observed. Successful reperfusion did not modify the relation of SBP with any of the outcomes. Conclusions: Maximum SBP in the first 6 hours following EVT is positively associated with worse functional outcome and an ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1161/STROKEAHA.120.033657 |
| الإتاحة: | https://doi.org/10.1161/STROKEAHA.120.033657Test https://pure.eur.nl/en/publications/52a7932b-2b5c-4960-94bb-922f93b9229aTest https://pure.eur.nl/ws/files/53419769/STROKEAHA.120.033657.pdfTest http://www.scopus.com/inward/record.url?scp=85119019290&partnerID=8YFLogxKTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.168D105F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1161/STROKEAHA.120.033657 |
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