Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients With Acute Ischemic Stroke

作者：Aristeidis H. Katsanos, Konark Malhotra, Niaz Ahmed, Georgios Seitidis, Eva Mistry, Dimitris Mavridis, Joon‐Tae Kim, Areti Angeliki Veroniki, Ilko Maier, Marius Matusevicius, Pooja Khatri, Mohammad Anadani, Nitin Goyal, Adam S Arthur, Amrou Sarraj, Shadi Yaghi, Ashkan Shoamanesh, Luciana Catanese, Μαρία Καντζάνου, Θεοδώρα Ψαλτοπούλου, Alexandros Rentzos, Marios Psychogios, Brian van Adel, Alejandro M Spiotta, Else Charlotte Sandset, Adam de Havenon, Andrei V. Alexandrov, Nils Petersen, Georgios Tsivgoulis · 发表于：Neurology · 年份：2021 · DOI：10.1212/wnl.0000000000013049 · 被引用次数：95 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Intracerebral and Subarachnoid Hemorrhage Research

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 ...