Title :

Mortality and disability according to baseline blood pressure in acute ischemic stroke patients treated by thrombectomy: a collaborative pooled analysis

Author(s) :

Maier, Benjamin [Auteur]

Gory, Benjamin [Auteur]
Département de neuro-radiologie
Université Claude Bernard Lyon 1 [UCBL]
Taylor, Guillaume [Auteur]

Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Blanc, Raphael [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]

Obadia, Michael [Auteur]

Abrivard, Marie [Auteur]

Smajda, Stanislas [Auteur]

Desilles, Jean-Philippe [Auteur]

Redjem, Hocine [Auteur]

Ciccio, Gabriele [Auteur]

Lukaszewicz, Anne-Claire [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Turjman, Francis [Auteur]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Riva, Roberto [Auteur]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Labeyrie, Paul-Emile [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
Duhamel, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Blacher, Jacques [Auteur]
Hôpital Hôtel-Dieu [Paris]
Piotin, Michel [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]

Lapergue, Bertrand [Auteur]
Hôpital Foch [Suresnes]
Mazighi, Mikael [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]

Université Paris Diderot, Sorbonne Paris Cité, Paris, France

Journal title :

Journal of the American Heart Association

Abbreviated title :

J Am Heart Assoc

Volume number :

6

Publication date :

2017-10-10

ISSN :

2047-9980

English keyword(s) :

thrombectomy
stroke management
blood pressure
ischemic
stroke
Mesh:Disability Evaluation*
Mesh:France
Mesh:Humans
Mesh:Hypertension/diagnosis
Mesh:Hypertension/mortality
Mesh:Hypertension/physiopathology*
Mesh:Linear Models
Mesh:Logistic Models
Mesh:Male
Mesh:Middle Aged
Mesh:Thrombectomy/mortality*
Mesh:Thrombectomy/adverse effects
Mesh:Stroke/therapy*
Mesh:Treatment Outcome
Mesh:Time Factors
Mesh:Stroke/physiopathology
Mesh:Stroke/mortality
Mesh:Stroke/diagnosis
Mesh:Risk Factors
Mesh:Registries
Mesh:Predictive Value of Tests
Mesh:Odds Ratio
Mesh:Aged
Mesh:Aged
Mesh:80 and over
Mesh:Blood Pressure*
Mesh:Brain Ischemia/diagnosis
Mesh:Brain Ischemia/mortality
Mesh:Brain Ischemia/physiopathology
Mesh:Brain Ischemia/therapy*
Mesh:Chi-Square Distribution
Mesh:Female

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

High blood pressure (BP) is associated with worse clinical outcomes in the setting of acute ischemic stroke, but the optimal blood pressure target is still a matter of debate. We aimed to study the association between ...
Show more >High blood pressure (BP) is associated with worse clinical outcomes in the setting of acute ischemic stroke, but the optimal blood pressure target is still a matter of debate. We aimed to study the association between baseline BP and mortality in acute ischemic stroke patients treated by mechanical thrombectomy. A total of 1332 acute ischemic stroke patients treated by mechanical thrombectomy were enrolled (from January 2012 to June 2016) in the ETIS (Endovascular Treatment in Ischemic Stroke) registry. Linear and polynomial logistic regression models were used to assess the association between BP and mortality and functional outcome at 90 days. Highest mortality was found at lower and higher baseline systolic blood pressure (SBP) values following a J- or U-shaped relationship, with a nadir at 157 mm Hg (95% confidence interval 143-170). When SBP values were categorized in 10-mm Hg increments, the odds ratio for all-cause mortality was 3.78 (95% confidence interval 1.50-9.55) for SBP<110 mm Hg and 1.81 (95% confidence interval 1.01-3.36) for SBP≥180 mm Hg using SBP≥150 to 160 mm Hg as reference. The rate of favorable outcome was the highest at low SBP values and lowest at high SBP values, with a nonlinear relationship; in unplanned exploratory analysis, an optimal threshold SBP≥177 mm Hg was found to predict unfavorable outcome (adjusted odds ratio 0.47; 95% confidence interval 0.31-0.70). In acute ischemic stroke patients treated by mechanical thrombectomy, baseline SBP is associated with all-cause mortality and favorable outcome. In contrast to mortality, favorable outcome rate was the highest at low SBP values and lowest at high SBP values. Further studies are warranted to confirm these findings.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:17:41Z
2020-04-16T09:51:32Z