Systolic blood pressure variability following endovascular thrombectomy and clinical outcome in acute ischemic stroke: A meta-analysis.
| Autor: | Nepal G; Department of Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, Nepal., Shrestha GS; Department of Anesthesiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Shing YK; Department of Internal Medicine, National University Hospital, Singapore City, Singapore., Muha A; Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA., Bhagat R; Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Acta neurologica Scandinavica [Acta Neurol Scand] 2021 Oct; Vol. 144 (4), pp. 343-354. Date of Electronic Publication: 2021 Jun 10. |
| DOI: | 10.1111/ane.13480 |
| Abstrakt: | Blood pressure variability (BPV) has been linked with the outcome of acute ischemic stroke (AIS) after endovascular thrombectomy (EVT). However, the association of the stroke outcome with specific short-term BPV parameters is unclear. We did a systematic literature search for studies published from January 2010 to September 2020. Eligibility criteria included studies with (1) AIS patients treated with EVT with or without thrombolysis; and (2) analysis of the association between short-term systolic BPV parameter and clinical outcomes. Systolic BPV parameters included standard deviation (SD), coefficient of Variation (CoV), successive Variation (SV), and Variation independent of mean. A total of 11 studies were meta-analyzed, comprising 3520 patients who underwent EVT. Lower odds of achieving good functional outcome at 3 months; that is, modified Rankin Scale (mRS) score ≤2 was associated with SD (OR, 0.854; p = .02), CoV (OR, 0.572; p = .04), SV (OR 0.41; p = .00) of systolic blood pressure (SBP). Likewise, higher odds of one-point increase in mRS score was associated with SD (OR 1.42; p = .03), CoV (OR 1.464; p = .00) and SV (OR 2.605; p = .00) of SBP. However, high BPV was not associated with symptomatic intracranial hemorrhage and all-cause mortality at 90 days. The association of BPV and early neurological deterioration was inconclusive. Based on the available studies, short-term systolic BPV is indicative of the clinical outcome of patients following EVT in AIS. Further research should focus on personalized blood pressure management strategies, rather than a one-size-fits-all approach. (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
| Databáze: | MEDLINE |
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