Stroke Outcomes Worse After Endovascular Thrombectomy, BP Variability

CHICAGO — Blood pressure variability following treatment of ischemic stroke with endovascular thrombectomy is associated with worse functional outcome, similar to outcomes associated with IV tPA. The findings were presented at the American Neurological Associaton 2015 Annual Meeting in Chicago.

Alicia Bennett, DO, of the University of Utah, and colleagues conducted a retrospective review of 127 acute ischemic stroke patients who underwent endovascular thrombectomy from 2005 to 2013. Calculations included blood pressure variation as the standard deviation and coefficient of variation of systolic blood pressure in 14,986 readings.

Analysis showed that a one quartile increase of systolic blood pressure standard deviation was linked to a one-point increase in modified Rankin Scale score at discharge and follow-up during six time points in the first five days of hospitalization (OR= 1.46-1.94, all P<0.05).

A 10mmHg increase in systolic blood pressure standard deviation in the first four days of hospitalization was associated with 1.9 to 2.7-fold greater odds of a one-point increase in Rankin score at follow-up. Risk factors included age, history of diabetes, hemoglobin A1c level, post-procedure TCI score, and post-procedure intracerebral hemorrhage.

The researchers stressed that the novel association between blood pressure variability and endovascular thrombectomy has a direct effect on patient care and therefore should be further investigated in a timely manner.

Reference

1. Bennett A et al. Abstract S225WIP. Presented at: American Neurological Association Annual Meeting 2015. September 27-29, 2015; Chicago.