Effect of blood pressure variability on the outcomes of acute ischemic stroke patients undergoing intravenous thrombolysis

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2024-11-25 DOI:10.1016/j.jocn.2024.110935

Mingwei Ma , Tingting Huang , Ning Ru , Xi Pan , Dapeng Wang

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Abstract

Background

There is limited research on the relationship between blood pressure variability (BPV) and outcomes among patients receiving intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). This study aimed to investigate the effect of 24-h BPV on the outcome of patients with AIS treated with IVT.

Methods

A retrospective analysis was conducted on clinical data of patients with AIS who had undergone IVT treatment. During the initial 24 h after IVT, various BPV parameters for systolic and diastolic blood pressure were calculated, including the maximum BP, minimum BP, mean BP, standard deviation, coefficient of variation, and average real variability (ARV). Follow-up was conducted at 90 days post-onset, with outcomes classified as “good” or “poor” based on a modified Rankin Scale score of ≤2 or >2, respectively.

Results

A total of 216 patients were included in the study and divided into two groups based on their outcomes: a good-outcome group (n = 151, 69.9 %) and a poor-outcome group (n = 65, 30.1 %). A comparison of the poor-outcome group with the other group revealed significant differences in age, baseline National Institutes of Health Stroke Scale, Trial of Org 10172 in Acute Stroke Treatment classification, diabetes mellitus, and atrial fibrillation (P < 0.05). The maximum systolic blood pressure (163.58 ± 19.76 vs. 173.91 ± 18.51 mmHg) and average rate of ventricular response (10.35 vs. 12.09) in the good-outcome group were lower than those in the poor-outcome group (all P < 0.05). After adjusting for confounding factors in the binary logistic regression analysis, the maximum systolic blood pressure (odds ratio = 1.023, 95 % confidence interval = 1.004–1.043, P = 0.019] and ARV (odds ratio = 1.103, 95 % confidence interval = 1.007–1.208, P = 0.035) were significantly associated with adverse outcomes.

Conclusion

The maximum systolic blood pressure and mean true variation rate were negatively correlated with outcomes.

Abstract Image

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血压变化对接受静脉溶栓治疗的急性缺血性脑卒中患者预后的影响

背景关于血压变异性（BPV）与急性缺血性卒中（AIS）静脉溶栓（IVT）患者预后之间关系的研究十分有限。本研究旨在探讨 24 小时 BPV 对接受 IVT 治疗的 AIS 患者预后的影响。方法对接受 IVT 治疗的 AIS 患者的临床数据进行回顾性分析。在 IVT 治疗后的最初 24 小时内，计算收缩压和舒张压的各种 BPV 参数，包括最大 BP、最小 BP、平均 BP、标准差、变异系数和平均实际变异性（ARV）。研究共纳入 216 名患者，并根据其结果分为两组：结果良好组（n = 151，69.9%）和结果不良组（n = 65，30.1%）。结果差组与其他组的比较显示，两组在年龄、美国国立卫生研究院卒中量表基线、急性卒中治疗中的 Org 10172 试验分类、糖尿病和心房颤动方面存在显著差异（P < 0.05）。良好结果组的最大收缩压（163.58 ± 19.76 vs. 173.91 ± 18.51 mmHg）和平均心室反应率（10.35 vs. 12.09）均低于不良结果组（均为 P <0.05）。在二元逻辑回归分析中调整混杂因素后，最大收缩压（几率比=1.023，95%置信区间=1.004-1.043，P=0.019]和ARV（几率比=1.103，95%置信区间=1.007-1.208，P=0.035）与不良结局显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.