Rebleeding After Aneurysmal Subarachnoid Hemorrhage in Two Centers Using Different Blood Pressure Management Strategies.

Background

High systolic blood pressure (SBP) after aneurysmal subarachnoid hemorrhage (aSAH) has been associated with an increased risk of rebleeding. It remains unclear if an SBP lowering strategy before aneurysm treatment decreases this risk without increasing the risk of a delayed cerebral ischemia (DCI). Therefore, we compared the rates of in-hospital rebleeding and DCI among patients with aSAH admitted in two tertiary care centers with different SBP management strategies.

Methods

Retrospective cohort study. Consecutive patients from Utrecht and Toulouse admitted within 24 h after the aSAH onset were enrolled. In Toulouse, the target SBP before aneurysm treatment was ≤140 mm Hg, while, in Utrecht, an increased SBP was only treated in extreme situations. We compared SBP levels, the incidence of rebleeding within 24 h after admission, and DCI during hospitalization.

Results

We enrolled 373 patients in Utrecht and 149 in Toulouse. The mean SBP on admission was similar but lower in Toulouse 4 h after admission (127.3 ± 17.4 vs. 138. ± 25.7 mmHg;

Conclusion

Our results suggest that an intensive SBP lowering strategy between admission and aneurysm treatment does not decrease the risk of rebleeding and does not increase the risk of DCI compared to a more conservative strategy.

Informations de copyright

Copyright © 2022 Calviere, Gathier, Rafiq, Koopman, Rousseau, Raposo, Albucher, Viguier, Geeraerts, Cognard, Rinkel, Vergouwen and Olivot.

Déclaration de conflit d'intérêts

Unrelated to this study, JA received a travel grant, speaker fees, or research funding grant from Bayer, Bristol Myers Squibb. LC received a travel grant, speaker fees, or research funding grant from Boehringer Ingelheim, Pfizer. NR received a travel grant, speaker fees, or research funding grant from Fullbright Fundation, Harvard University and Philippe Foundation. CC received a travel grant, speaker fees, or research funding grant from Medtronic Cerenovus StrykerMIVI Neuroscience, Sensome, Microvention. J-MO received travel grant, speaker fees, or research funding grant from Abbvie, Aptoll, Medtronic, Bristol Myers Squibb. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.