Jae Wook Jung, Young Dae Kim, JoonNyung Heo, Hyungwoo Lee, Byung Moon Kim, Dong Joon Kim, Na Young Shin, Haram Joo, Bang-Hoon Cho, Seong Hwan Ahn, Hyungjong Park, Sung-Il Sohn, Jeong-Ho Hong, Jaeseob Yun, Tae-Jin Song, Yoonkyung Chang, Gyu Sik Kim, Kwon-Duk Seo, Kijeong Lee, Jun Young Chang, Jung Hwa Seo, Sukyoon Lee, Jang-Hyun Baek, Han-Jin Cho, Dong Hoon Shin, Jinkwon Kim, Joonsang Yoo, Minyoul Baik, Yo Han Jung, Yang-Ha Hwang, Chi Kyung Kim, Jae Guk Kim, Il Hyung Lee, Jin Kyo Choi, Chan Joo Lee, Sungha Park, Soyoung Jeon, Hye Sun Lee, Kwang Hyun Kim, Sun U Kwon, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam
{"title":"静脉降压药与血管内取栓成功后功能结局的关系。","authors":"Jae Wook Jung, Young Dae Kim, JoonNyung Heo, Hyungwoo Lee, Byung Moon Kim, Dong Joon Kim, Na Young Shin, Haram Joo, Bang-Hoon Cho, Seong Hwan Ahn, Hyungjong Park, Sung-Il Sohn, Jeong-Ho Hong, Jaeseob Yun, Tae-Jin Song, Yoonkyung Chang, Gyu Sik Kim, Kwon-Duk Seo, Kijeong Lee, Jun Young Chang, Jung Hwa Seo, Sukyoon Lee, Jang-Hyun Baek, Han-Jin Cho, Dong Hoon Shin, Jinkwon Kim, Joonsang Yoo, Minyoul Baik, Yo Han Jung, Yang-Ha Hwang, Chi Kyung Kim, Jae Guk Kim, Il Hyung Lee, Jin Kyo Choi, Chan Joo Lee, Sungha Park, Soyoung Jeon, Hye Sun Lee, Kwang Hyun Kim, Sun U Kwon, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam","doi":"10.1161/STROKEAHA.125.051696","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intravenous antihypertensives are frequently used to control blood pressure after successful endovascular thrombectomy (EVT), yet studies investigating the relationship between intravenous antihypertensive use and functional outcomes after successful EVT remain limited.</p><p><strong>Methods: </strong>We conducted an exploratory secondary analysis of the OPTIMAL-BP trial (Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure Control), which compared intensive (systolic blood pressure <140 mm Hg) versus conventional blood pressure management (systolic blood pressure, 140-180 mm Hg) within the first 24 hours after successful recanalization across 19 stroke centers in South Korea between June 2020 and November 2022. Patients were classified according to the administration of intravenous antihypertensives within the initial 24 hours after enrollment. The primary efficacy outcome was functional independence (modified Rankin Scale score of 0-2) at 3 months.</p><p><strong>Results: </strong>Of the 302 patients (median, 75 years; 180 [59.6%] men), 141 (46.7%) received intravenous antihypertensives within the first 24 hours after EVT. Among the 141 patients who received intravenous antihypertensives, 133 (94.3%) were treated with nicardipine, 10 (7.0%) received labetalol, and 2 (1.4%) were administered both drugs. Patients who received intravenous antihypertensives had significantly lower rates of functional independence at 3 months (adjusted odds ratio, 0.51 [95% CI, 0.27-0.95]; <i>P</i>=0.035) and excellent neurological recovery at 24 hours (adjusted odds ratio, 0.46 [95% CI, 0.22-0.94]; <i>P</i>=0.036), as well as higher stroke-related mortality rates (adjusted odds ratio, 4.21 [95% CI, 1.24-16.4]; <i>P</i>=0.027), compared with patients who did not receive intravenous antihypertensives. Symptomatic intracerebral hemorrhage was not significantly different between groups (adjusted odds ratio, 1.67 [95% CI, 0.68-4.19]; <i>P</i>=0.267).</p><p><strong>Conclusions: </strong>The use of intravenous antihypertensives within the first 24 hours after successful EVT was associated with worse functional outcomes at 3 months. This finding highlights the need for a cautious assessment of the risks and benefits of administering intravenous antihypertensives immediately after EVT.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04205305.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":7.8000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association Between Intravenous Antihypertensives and Functional Outcome After Successful Endovascular Thrombectomy.\",\"authors\":\"Jae Wook Jung, Young Dae Kim, JoonNyung Heo, Hyungwoo Lee, Byung Moon Kim, Dong Joon Kim, Na Young Shin, Haram Joo, Bang-Hoon Cho, Seong Hwan Ahn, Hyungjong Park, Sung-Il Sohn, Jeong-Ho Hong, Jaeseob Yun, Tae-Jin Song, Yoonkyung Chang, Gyu Sik Kim, Kwon-Duk Seo, Kijeong Lee, Jun Young Chang, Jung Hwa Seo, Sukyoon Lee, Jang-Hyun Baek, Han-Jin Cho, Dong Hoon Shin, Jinkwon Kim, Joonsang Yoo, Minyoul Baik, Yo Han Jung, Yang-Ha Hwang, Chi Kyung Kim, Jae Guk Kim, Il Hyung Lee, Jin Kyo Choi, Chan Joo Lee, Sungha Park, Soyoung Jeon, Hye Sun Lee, Kwang Hyun Kim, Sun U Kwon, Oh Young Bang, Ji Hoe Heo, Hyo Suk Nam\",\"doi\":\"10.1161/STROKEAHA.125.051696\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Intravenous antihypertensives are frequently used to control blood pressure after successful endovascular thrombectomy (EVT), yet studies investigating the relationship between intravenous antihypertensive use and functional outcomes after successful EVT remain limited.</p><p><strong>Methods: </strong>We conducted an exploratory secondary analysis of the OPTIMAL-BP trial (Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure Control), which compared intensive (systolic blood pressure <140 mm Hg) versus conventional blood pressure management (systolic blood pressure, 140-180 mm Hg) within the first 24 hours after successful recanalization across 19 stroke centers in South Korea between June 2020 and November 2022. Patients were classified according to the administration of intravenous antihypertensives within the initial 24 hours after enrollment. The primary efficacy outcome was functional independence (modified Rankin Scale score of 0-2) at 3 months.</p><p><strong>Results: </strong>Of the 302 patients (median, 75 years; 180 [59.6%] men), 141 (46.7%) received intravenous antihypertensives within the first 24 hours after EVT. Among the 141 patients who received intravenous antihypertensives, 133 (94.3%) were treated with nicardipine, 10 (7.0%) received labetalol, and 2 (1.4%) were administered both drugs. Patients who received intravenous antihypertensives had significantly lower rates of functional independence at 3 months (adjusted odds ratio, 0.51 [95% CI, 0.27-0.95]; <i>P</i>=0.035) and excellent neurological recovery at 24 hours (adjusted odds ratio, 0.46 [95% CI, 0.22-0.94]; <i>P</i>=0.036), as well as higher stroke-related mortality rates (adjusted odds ratio, 4.21 [95% CI, 1.24-16.4]; <i>P</i>=0.027), compared with patients who did not receive intravenous antihypertensives. Symptomatic intracerebral hemorrhage was not significantly different between groups (adjusted odds ratio, 1.67 [95% CI, 0.68-4.19]; <i>P</i>=0.267).</p><p><strong>Conclusions: </strong>The use of intravenous antihypertensives within the first 24 hours after successful EVT was associated with worse functional outcomes at 3 months. This finding highlights the need for a cautious assessment of the risks and benefits of administering intravenous antihypertensives immediately after EVT.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04205305.</p>\",\"PeriodicalId\":21989,\"journal\":{\"name\":\"Stroke\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":7.8000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/STROKEAHA.125.051696\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/STROKEAHA.125.051696","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Association Between Intravenous Antihypertensives and Functional Outcome After Successful Endovascular Thrombectomy.
Background: Intravenous antihypertensives are frequently used to control blood pressure after successful endovascular thrombectomy (EVT), yet studies investigating the relationship between intravenous antihypertensive use and functional outcomes after successful EVT remain limited.
Methods: We conducted an exploratory secondary analysis of the OPTIMAL-BP trial (Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure Control), which compared intensive (systolic blood pressure <140 mm Hg) versus conventional blood pressure management (systolic blood pressure, 140-180 mm Hg) within the first 24 hours after successful recanalization across 19 stroke centers in South Korea between June 2020 and November 2022. Patients were classified according to the administration of intravenous antihypertensives within the initial 24 hours after enrollment. The primary efficacy outcome was functional independence (modified Rankin Scale score of 0-2) at 3 months.
Results: Of the 302 patients (median, 75 years; 180 [59.6%] men), 141 (46.7%) received intravenous antihypertensives within the first 24 hours after EVT. Among the 141 patients who received intravenous antihypertensives, 133 (94.3%) were treated with nicardipine, 10 (7.0%) received labetalol, and 2 (1.4%) were administered both drugs. Patients who received intravenous antihypertensives had significantly lower rates of functional independence at 3 months (adjusted odds ratio, 0.51 [95% CI, 0.27-0.95]; P=0.035) and excellent neurological recovery at 24 hours (adjusted odds ratio, 0.46 [95% CI, 0.22-0.94]; P=0.036), as well as higher stroke-related mortality rates (adjusted odds ratio, 4.21 [95% CI, 1.24-16.4]; P=0.027), compared with patients who did not receive intravenous antihypertensives. Symptomatic intracerebral hemorrhage was not significantly different between groups (adjusted odds ratio, 1.67 [95% CI, 0.68-4.19]; P=0.267).
Conclusions: The use of intravenous antihypertensives within the first 24 hours after successful EVT was associated with worse functional outcomes at 3 months. This finding highlights the need for a cautious assessment of the risks and benefits of administering intravenous antihypertensives immediately after EVT.
期刊介绍：
Stroke is a monthly publication that collates reports of clinical and basic investigation of any aspect of the cerebral circulation and its diseases. The publication covers a wide range of disciplines including anesthesiology, critical care medicine, epidemiology, internal medicine, neurology, neuro-ophthalmology, neuropathology, neuropsychology, neurosurgery, nuclear medicine, nursing, radiology, rehabilitation, speech pathology, vascular physiology, and vascular surgery.
The audience of Stroke includes neurologists, basic scientists, cardiologists, vascular surgeons, internists, interventionalists, neurosurgeons, nurses, and physiatrists.
Stroke is indexed in Biological Abstracts, BIOSIS, CAB Abstracts, Chemical Abstracts, CINAHL, Current Contents, Embase, MEDLINE, and Science Citation Index Expanded.
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