Effect of blood pressure variability within 24 h after endovascular thromboectomy on early neurological improvement in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2021.07.002
- VernacularTitle:血管内血栓切除术后24 h血压变异性对急性缺血性卒中患者早期神经功能改善的影响
- Author:
Qifei QU
1
;
Hong ZHOU
;
Hongzhi ZHOU
;
Xinmin WU
;
Tian XU
;
Kaifu KE
Author Information
1. 南通市通州区人民医院神经内科 226399
- Keywords:
Stroke;
Brain ischemia;
Blood pressure;
Endovascular procedures;
Thrombectomy;
Treatment outcome;
Time factors;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2021;29(7):485-490
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between 24 h blood pressure variability and early neurological improvement (ENI) in patients with large vessel occlusion (LVO) after endovascular thrombectomy (ET).Methods:Patients with LVO received ET in the Emergency Department, the Affiliated Hospital of Nantong University from January 2012 to February 2018 were enrolled retrospectively. During the first 24 h after ET, the blood pressure was recorded every 2 h, and blood pressure variability was evaluated by standard deviation (SD) and successive variation (SV). At 24 h after ET, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated again. The re-evaluation of 0 point or a decrease of ≥4 from the baseline score was defined as ENI. Multivariate logistic regression analysis was used to evaluate the relationship between blood pressure variability and ENI. Results:A total of 74 patients with LVO received ET were enrolled, of which 39 (52.7%) had ENI. Univariate analysis showed that the proportion of patients with good recanalization in the ENI group after procedure were significantly higher than that in the non-ENI group ( P<0.05), while the average systolic blood pressure, average diastolic blood pressure, systolic blood pressure variability (SBPV) -SD and SBPV-SV within 24 h after ET and baseline total cholesterol level were significantly lower than those in the non-ENI group (all P<0.05). Multivariate logistic regression analysis showed that higher SBPV-SV was an independent risk factor for non-ENI (odds ratio 1.223, 95% confidence interval 1.038-1.440; P=0.016). Conclusion:Higher SBPV-SV after ET is associated with poor early neurological improvement in patients with LVO, and it is expected to be a potential target for blood pressure management in patients after ET.
