Systolic Blood Pressure Variability is Associated with Severe Hemorrhagic Transformation in the Early Stage After Thromb
- PDF / 398,388 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 108 Downloads / 194 Views
ORIGINAL ARTICLE
Systolic Blood Pressure Variability is Associated with Severe Hemorrhagic Transformation in the Early Stage After Thrombolysis Keqin Liu 1,2 & Shenqiang Yan 1 & Sheng Zhang 1 & Yang Guo 1 & Min Lou 1
Received: 1 December 2015 / Revised: 17 January 2016 / Accepted: 11 February 2016 # Springer Science+Business Media New York 2016
Abstract The present study investigates the association between hour-to-hour blood pressure (BP) variability and severe hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) during hyperacute stage. We analyzed hour-to-hour BP measurement within 24 h after IVT in patients with acute ischemic stroke. We calculated the maximum, minimum, and average (mean) of 24-h BP values, and BP variability profiles including standard deviation (SD), average squared difference between successive measurements (SV), average squared difference between rise and drop successive measurements (SV rise and SV drop), and maximum of SV rise and SV drop (SVrisemax and SVdropmax) after quartering 0-to-24 h BP course. HT was classified as hemorrhagic infarction (HI) or parenchymal hematoma (PH). Symptomatic intracerebral hemorrhage (sICH) was defined as HT with worsening of the National Institute of Health Stroke Scale score by ≥4 points or leading to death. Severe HT was defined as either PH or sICH. Totally, 461 patients were included. We observed HT in 142 (30.8 %), PH in 43 (9.3 %), and sICH in 12 (2.6 %) patients. Binary logistic regression indicated that SBPSD and SBPSV within the first 24 h were associated with sICH (OR, 4.538; 95 % CI, 1.834–11.230; p = 0.001 and OR, 6.117; 95 % CI, 2.000–18.711; p = 0.002) and PH (OR, 2.146; 95 % CI, 1.106–4.165; p = 0.024 and OR, 2.202; 95 % CI, 1.046–4.633; p = 0.038). For the SBP SV parameters among four periods of Keqin Liu and Shenqiang Yan contributed equally to this work. * Min Lou [email protected]
1
Department of Neurology, School of Medicine, The 2nd Affiliated Hospital of Zhejiang University, #88 Jiefang Road, Hangzhou, China
2
Department of Neurology, Hangzhou First People’s Hospital, Hangzhou, China
the initial 24 h, only SV, SVrise, and SVrisemax during the first 6 h were significantly associated with sICH (OR, 2.785; 95 % CI, 1.294–5.994; p = 0.009; OR, 1.825; 95 % CI, 1.110– 3.002; p = 0.018 and OR, 1.495; 95 % CI, 1.039–2.149; p = 0.030) and PH (OR, 2.088; 95 % CI, 1.287–3.387; p = 0.003; OR, 1.501; 95 % CI, 1.044–2.156; p = 0.028 and OR, 1.334; 95 % CI, 1.023–1.739; p = 0.033). High systolic BP variability during the first 6 h after IVT was related with severe HTs, which highlights the potential predictability to severe HTs. Keywords Acute ischemic stroke . Thrombolysis . Blood pressure . Hemorrhagic transformation
Introduction Hemorrhagic transformation (HT), especially symptomatic intracerebral hemorrhage (sICH), is the most fearful complication of intravenous thrombolysis (IVT) for acute ischemic stroke. Most sICHs occur within the first 24 h after intravenous recombinant tissue plasminogen activator (rt-PA) and
Data Loading...
