Blood Pressure Goals and Clinical Outcomes after Successful Endovascular Therapy: A Multicenter Study

被引：63

作者：

Anadani, Mohammad ^{[1
,2
]}

Arthur, Adam S. ^{[2
]}

Tsivgoulis, Georgios ^{[3
]}

Simpson, Kit N. ^{[4
]}

Alawieh, Ali ^{[1
]}

Orabi, Yser ^{[2
]}

Goyal, Nitin ^{[7
]}

Alexandrov, Andrei, V ^{[6
]}

Maier, Ilko L. ^{[7
]}

Psychogios, Marios-Nikos ^{[7
]}

Jan Liman ^{[7
]}

Brinton, Daniel ^{[5
]}

Swisher, Christa B. ^{[8
]}

Shah, Shreyash ^{[8
]}

Inamullah, Ovais ^{[8
]}

Keyrouz, Salah ^{[9
]}

Kansagra, Akash P. ^{[9
]}

Allen, Michelle ^{[9
]}

Giles, James A. ^{[9
]}

Wolfe, Stacey Q. ^{[10
]}

Fargen, Kyle M. ^{[10
]}

Gory, Benjamin ^{[11
]}

De Marini, Pierre ^{[11
]}

Kan, Peter ^{[12
]}

Nascimento, Fabio A. ^{[13
]}

Almallouhi, Eyad ^{[2
]}

Petersen, Nils ^{[14
]}

Kodali, Sreeja ^{[14
]}

Rahman, Shareena ^{[8
]}

Richard, Sebastien ^{[15
]}

Spiotta, Alejandro M. ^{[1
]}

机构：

[1] Med Univ South Carolina, Dept Neurosurg, Charleston, SC 29425 USA

[2] Med Univ South Carolina, Dept Neurol, Charleston, SC 29425 USA

[3] Univ Tennessee, Hlth Sci Ctr, Dept Neurosurg, Memphis, TN USA

[4] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Sch Med, Dept Neurol, Athens, Greece

[5] Med Univ South Carolina, Dept Healthcare Leadership & Management, Charleston, SC 29425 USA

[6] Univ Tennessee, Dept Neurol, Hlth Sci Ctr, Memphis, TN USA

[7] Univ Med Ctr Gottingen, Dept Neurol, Gottingen, Germany

[8] Duke Univ Hosp, Dept Neurol, Durham, NC USA

[9] Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA

[10] Wake Forest Univ, Dept Neurosurg, Winston Salem, NC 27101 USA

[11] Univ Hosp Nancy, Dept Diagnost & Therapeut Neuroradiol, Nancy, France

[12] Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA

[13] Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA

[14] Yale New Haven Med Ctr, Dept Neurol, 20 York St, New Haven, CT 06504 USA

[15] Univ Hosp Nancy, Dept Neurol, Stroke Unit, Nancy, France

来源：

ANNALS OF NEUROLOGY | 2020年 / 87卷 / 06期

关键词：

ACUTE ISCHEMIC-STROKE; THROMBOLYSIS;

D O I：

10.1002/ana.25716

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective Elevated systolic blood pressure (SBP) after successful revascularization (SR) via endovascular therapy (EVT) is a known predictor of poor outcome. However, the optimal SBP goal following EVT is still unknown. Our objective was to compare functional and safety outcomes between different SBP goals after EVT with SR. Methods This international multicenter study included 8 comprehensive stroke centers and patients with anterior circulation large vessel occlusion who were treated with EVT and achieved SR. SR was defined as modified thrombolysis in cerebral ischemia 2b to 3. Patients were divided into 3 groups based on SBP goal in the first 24 hours after EVT. Inverse probability of treatment weighting (IPTW) propensity analysis was used to assess the effect of different SBP goals on clinical outcomes. Results A total of 1,019 patients were included. On IPTW analysis, the SBP goal of <140mmHg was associated with a higher likelihood of good functional outcome and lower odds of hemicraniectomy compared to SBP goal of <180mmHg. Similarly, SBP goal of <160mmHg was associated with lower odds of mortality compared to SBP goal of <180mmHg. In subgroup analysis including only patients with pre-EVT SBP of >= 140mmHg, an SBP of <140mmHg was associated with a higher likelihood of good functional outcome, lower odds of symptomatic intracranial hemorrhage, and lower odds of requirement for hemicraniectomy compared to SBP goal of SBP goals of <140 and < 160mmHg following SR with EVT appear to be associated with better clinical outcomes than SBP of <180mmHg. ANN NEUROL 2020

引用

页码：830 / 839

页数：10

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