Impact of Early Blood Pressure Variability on Stroke Outcomes After Thrombolysis The SAMURAI rt-PA Registry

被引：99

作者：

Endo, Kaoru ^{[1
]}

Kario, Kazuomi ^{[2
]}

Koga, Masatoshi ^{[1
]}

Nakagawara, Jyoji ^{[3
]}

Shiokawa, Yoshiaki ^{[4
]}

Yamagami, Hiroshi ^{[5
]}

Furui, Eisuke ^{[6
]}

Kimura, Kazumi ^{[7
]}

Hasegawa, Yasuhiro ^{[8
]}

Okada, Yasushi ^{[9
]}

Okuda, Satoshi ^{[10
]}

Namekawa, Michito ^{[2
]}

Miyagi, Tetsuya ^{[1
]}

Osaki, Masato ^{[1
]}

Minematsu, Kazuo ^{[1
]}

Toyoda, Kazunori ^{[1
]}

机构：

[1] Natl Cerebral & Cardiovasc Ctr, Suita, Osaka 5658565, Japan

[2] Jichi Med Univ, Sch Med, Shimotsuke, Japan

[3] Nakamura Mem Hosp, Sapporo, Hokkaido, Japan

[4] Kyorin Univ, Sch Med, Mitaka, Tokyo 181, Japan

[5] Kobe City Med Ctr Gen Hosp, Kobe, Hyogo, Japan

[6] Kohnan Hosp, Sendai, Miyagi, Japan

[7] Kawasaki Med Sch, Kurashiki, Okayama, Japan

[8] St Marianna Univ, Sch Med, Kawasaki, Kanagawa, Japan

[9] NHO Kyushu Med Ctr, Fukuoka, Japan

[10] NHO Nagoya Med Ctr, Nagoya, Aichi, Japan

来源：

STROKE | 2013年 / 44卷 / 03期

关键词：

acute stroke; blood pressure variability; hypertension; tissue plasminogen activator; ISCHEMIC-STROKE; INTRAVENOUS THROMBOLYSIS; SAFE IMPLEMENTATION; ASSOCIATION; THERAPY;

D O I：

10.1161/STROKEAHA.112.681007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-The present study determines associations between early blood pressure (BP) variability and stroke outcomes after intravenous thrombolysis. Methods-In 527 stroke patients receiving intravenous alteplase (0.6 mg/kg), BP was measured 8 times within the first 25 hours. BP variability was determined as Delta BP (maximum-minimum), standard deviation (SD), coefficient of variation, and successive variation. Results-The systolic BP course was lower among patients with modified Rankin Scale (mRS) 0 to 1 than those without (P<0.001). Most of systolic BP variability profiles were significantly associated with outcomes. Adjusted odds ratios (95% confidence interval) per 10 mm Hg (or 10% for coefficient of variation) on symptomatic intracerebral hemorrhage were as follows:Delta BP, 1.33 (1.08-1.66); SD, 2.52 (1.26-5.12); coefficient of variation, 3.15 (1.12-8.84); and successive variation, 1.82 (1.04-3.10). The respective values were 0.88 (0.77-0.99), 0.73 (0.48-1.09), 0.77 (0.43-1.34), and 0.76 (0.56-1.03) for 3-month mRS 0 to 1; and 1.40 (1.14-1.75), 2.85 (1.47-5.65), 4.67 (1.78-12.6), and 1.99 (1.20-3.25) for death. Initial BP values before thrombolysis were not associated with any outcomes. Conclusions-Early systolic BP variability was positively associated with symptomatic intracerebral hemorrhage and death after intravenous thrombolysis. (Stroke. 2013;44:816-818.)

引用

页码：816 / +

页数：9

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