Admission Blood Pressure and Outcome of Endovascular Therapy: Secondary Analysis of ASTER Trial.
Aged
Aged, 80 and over
Blood Pressure
Brain Ischemia
/ complications
Cerebral Hemorrhage
/ etiology
Endovascular Procedures
/ adverse effects
Female
Humans
Hypertension
/ complications
Male
Middle Aged
Patient Admission
Recovery of Function
Risk Factors
Stroke
/ complications
Thrombectomy
/ adverse effects
Time Factors
Treatment Outcome
Blood pressure
Cerebral hemorrhage
Stroke
Thrombectomy
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
05
08
2020
accepted:
21
09
2020
pubmed:
6
10
2020
medline:
15
12
2020
entrez:
5
10
2020
Statut:
ppublish
Résumé
Elevated blood pressure (BP) is common among patients presenting with acute ischemic stroke due to large vessel occlusions. The literature is inconsistent regarding the association between admission BP and outcome of mechanical thrombectomy (MT). Moreover, it is unclear whether the first line thrombectomy strategy (stent retriever [SR] versus contact aspiration [CA]) modifies the relationship between BP and outcome. This is a post hoc analysis of the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) randomized trial. BP was measured prior to randomization in all included patients. Co-primary outcomes included 90-day functional independence (modified Rankin Scale [mRS] 0-2) and successful revascularization (modified Treatment in Cerebral Ischemia [mTICI] 2b-3). Secondary outcomes included symptomatic intracerebral hemorrhage (sICH) and parenchymal hemorrhage (PH) within 24 hours. A total of 381 patients were included in the present study. Mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 148 (26) mm Hg and 81 (16) mm Hg, respectively. There was no association between SBP or DBP and successful revascularization or 90-day functional independence. Similarly, there was no association between admission SBP or DBP with sICH or PH. Subgroup analysis based on the first-line thrombectomy strategy revealed similar results with no heterogeneity across groups. Admission BP was not associated with functional, angiographic or safety outcomes. Results were similar in both CA and CA groups.
Sections du résumé
BACKGROUND
BACKGROUND
Elevated blood pressure (BP) is common among patients presenting with acute ischemic stroke due to large vessel occlusions. The literature is inconsistent regarding the association between admission BP and outcome of mechanical thrombectomy (MT). Moreover, it is unclear whether the first line thrombectomy strategy (stent retriever [SR] versus contact aspiration [CA]) modifies the relationship between BP and outcome.
METHODS
METHODS
This is a post hoc analysis of the ASTER (Contact Aspiration Versus Stent Retriever for Successful Revascularization) randomized trial. BP was measured prior to randomization in all included patients. Co-primary outcomes included 90-day functional independence (modified Rankin Scale [mRS] 0-2) and successful revascularization (modified Treatment in Cerebral Ischemia [mTICI] 2b-3). Secondary outcomes included symptomatic intracerebral hemorrhage (sICH) and parenchymal hemorrhage (PH) within 24 hours.
RESULTS
RESULTS
A total of 381 patients were included in the present study. Mean (SD) systolic BP (SBP) and diastolic BP (DBP) were 148 (26) mm Hg and 81 (16) mm Hg, respectively. There was no association between SBP or DBP and successful revascularization or 90-day functional independence. Similarly, there was no association between admission SBP or DBP with sICH or PH. Subgroup analysis based on the first-line thrombectomy strategy revealed similar results with no heterogeneity across groups.
CONCLUSION
CONCLUSIONS
Admission BP was not associated with functional, angiographic or safety outcomes. Results were similar in both CA and CA groups.
Identifiants
pubmed: 33017755
pii: S1052-3057(20)30765-5
doi: 10.1016/j.jstrokecerebrovasdis.2020.105347
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
105347Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.