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Magnitude of Blood Pressure Change After Endovascular Therapy and Outcomes: Insight From the BP-TARGET Trial.

Collaborators (27)

Author information

Affiliations

  • 1. Department of Neurology, Washington University, St Louis, MO (M.A.).
      Authors
    • Anadani M 1
    (1 author)
  • 2. Department of Interventional Neuroradiology, Hôpital Fondation Ophtalmologique Adolphe de Rothschild, Paris, France (B.M., S.E., J.-P.D., R.B., M.P., M.M.).
      Authors
    • Maïer B 2, 7, 8
    • Escalard S 2
    • Mazighi M 2, 7, 8
    (3 authors)
  • 3. University of Lille, CHU Lille, ULR 2694-METRICS: Évaluation des technologies de santé et des pratiques médicales, France (J.L.).
      Authors
    • Labreuche J 3
    (1 author)
  • 4. Department of Neurology, University of Utah, Salt Lake City (A.d.H.).
      Authors
    • de Havenon A 4
    (1 author)
  • 5. Division of Neurology, Department of Neurology, Stroke Centre, Foch Hospital, University Versailles Saint-Quentin en Yvelines, Suresnes, France (B.L.).
      Authors
    • Lapergue B 5
    (1 author)
    • Show all (8)

ORCIDs linked to this article

Show all (12)

Stroke, 03 Feb 2022, 53(3):719-727
https://doi.org/10.1161/strokeaha.121.036701 PMID: 35109685 

Abstract 

Background and purpose

To assess the association between systolic blood pressure change (ΔSBP) at different time intervals after successful reperfusion with radiographic and clinical outcomes.

Methods

This is a post hoc analysis of the BP-TARGET multicenter trial (Blood Pressure Target in Acute Stroke to Reduce Hemorrhage After Endovascular Therapy). ΔSBP was defined as end of procedure SBP minus mean SBP at different time intervals (15-60 minutes, 1-6 hours, and 6-24 hours postprocedure). The primary outcome was the poor functional outcome (90-day modified Rankin Scale score 3-6).

Results

We included a total of 267 patients (130 in the intensive treatment group). Compared with patients with favorable outcome, patients with poor outcome had lower ΔSBP (less SBP reduction) at all times intervals. After adjusting for potential confounders including baseline SBP, both ΔSBP15-60M and ΔSBP6-24H were associated with lower odds of poor outcome (adjusted odds ratio per 5 mm Hg SBP reduction, 0.89 [95% CI, 0.81-0.99], and adjusted odds ratio 0.82 [95% CI, 0.73-0.92], respectively). Concerning safety outcomes, patients with intraparenchymal hemorrhage had lower ΔSBP at all time intervals. ΔSBP15-60M was associated with lower odds of any intraparenchymal hemorrhage (adjusted odds ratio per 5 mm Hg SBP reduction 0.91 [95% CI, 0.83-0.99]). Conversely, ΔSBP was not associated with mortality or neurological deterioration at any time interval.

Conclusions

After successful reperfusion, ΔSBP had a linear relationship with poor outcome and the risk of poor outcome was higher with less reduction from the baseline SBP. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03160677.

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Read article at publisher's site: https://doi.org/10.1161/strokeaha.121.036701

Read article for free, from open access legal sources, via Unpaywall: https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.121.036701Unpaywall

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