Effect of blood pressure variability in ...
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Article dans une revue scientifique: Article original
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Title :
Effect of blood pressure variability in the randomized controlled BP TARGET trial.
Author(s) :
Maïer, B. [Auteur]
Université de Tours [UT]
Gory, B. [Auteur]
Université de Lorraine [UL]
Lapergue, B. [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Sibon, I. [Auteur]
Université de Bordeaux [UB]
Escalard, S. [Auteur]
Kyheng, Maéva [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
De Havenon, A. [Auteur]
Petersen, N. [Auteur]
Anadani, M. [Auteur]
Gayat, E. [Auteur]
Marqueurs cardiovasculaires en situation de stress [MASCOT (UMR_S_942 / U942)]
Boursin, P. [Auteur]
Ben Maacha, M. [Auteur]
Desilles, J. P. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Blanc, R. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Piotin, M. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Halimi, J. M. [Auteur]
Université de Tours [UT]
Mazighi, M. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Université de Tours [UT]
Gory, B. [Auteur]
Université de Lorraine [UL]
Lapergue, B. [Auteur]
Université de Versailles Saint-Quentin-en-Yvelines [UVSQ]
Sibon, I. [Auteur]
Université de Bordeaux [UB]
Escalard, S. [Auteur]
Kyheng, Maéva [Auteur]
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
De Havenon, A. [Auteur]
Petersen, N. [Auteur]
Anadani, M. [Auteur]
Gayat, E. [Auteur]
Marqueurs cardiovasculaires en situation de stress [MASCOT (UMR_S_942 / U942)]
Boursin, P. [Auteur]
Ben Maacha, M. [Auteur]
Desilles, J. P. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Blanc, R. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Piotin, M. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Halimi, J. M. [Auteur]
Université de Tours [UT]
Mazighi, M. [Auteur]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Journal title :
European Journal of Neurology
Abbreviated title :
Eur J Neurol
Volume number :
29
Pages :
P. 771-781
Publication date :
2022-03
ISSN :
1468-1331
English keyword(s) :
blood pressure
disability
endovascular therapy
stroke
thrombectomy
disability
endovascular therapy
stroke
thrombectomy
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background and purpose
The Blood Pressure Target in Acute Ischemic Stroke to Reduce Hemorrhage After Endovascular Therapy (BP TARGET) trial evaluated whether an intensive systolic blood pressure (SBP) target resulted ...
Show more >Background and purpose The Blood Pressure Target in Acute Ischemic Stroke to Reduce Hemorrhage After Endovascular Therapy (BP TARGET) trial evaluated whether an intensive systolic blood pressure (SBP) target resulted in reduced rates of intracranial hemorrhage (ICH) after successful endovascular therapy (EVT) but did not assess the effect of blood pressure variability (BPV) on functional outcomes and ICH occurrence. We sought to evaluate this question in the BP TARGET trial. Methods We performed a post hoc analysis of the BP TARGET trial and included patients with at least 50% of blood pressure (BP) recordings during the first 24 h after EVT. BPV parameters were SBP and diastolic BP (DBP) coefficient of variation (CV), standard deviation (SD), maximum–minimum (max–min), successive variation (SV), and time rate. The primary outcome was favorable functional outcome (3-month modified Rankin Scale between 0 and 2); the secondary outcome was the rate of ICH at 24 h. Results We included 290 patients (mean number of BP measures = 30.4, SD = 8.0). BPV parameters (SBPSD, SBPmax–min, SBPCV) were higher in the intensive SBP target group. Only DBP BPV parameters were associated with worse functional outcomes in the unadjusted model (DBPSD, DBPmax–min, DBPCV, and DBPSV), but not after adjustment. Higher SBPmax–min was associated with worse functional outcomes in Thrombolysis in Cerebral Infarction 2B patients (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.38–1.02), but not in patients with complete reperfusion (OR = 1.27, 95% CI = 0.80–2.02, p for heterogeneity (phet=0.037). None of the BPV parameters was associated with ICH, regardless of the randomization group or the reperfusion grade. Conclusions BPV was significantly higher in the intensive SBP target group but was not associated with functional outcome or ICH.Show less >
Show more >Background and purpose The Blood Pressure Target in Acute Ischemic Stroke to Reduce Hemorrhage After Endovascular Therapy (BP TARGET) trial evaluated whether an intensive systolic blood pressure (SBP) target resulted in reduced rates of intracranial hemorrhage (ICH) after successful endovascular therapy (EVT) but did not assess the effect of blood pressure variability (BPV) on functional outcomes and ICH occurrence. We sought to evaluate this question in the BP TARGET trial. Methods We performed a post hoc analysis of the BP TARGET trial and included patients with at least 50% of blood pressure (BP) recordings during the first 24 h after EVT. BPV parameters were SBP and diastolic BP (DBP) coefficient of variation (CV), standard deviation (SD), maximum–minimum (max–min), successive variation (SV), and time rate. The primary outcome was favorable functional outcome (3-month modified Rankin Scale between 0 and 2); the secondary outcome was the rate of ICH at 24 h. Results We included 290 patients (mean number of BP measures = 30.4, SD = 8.0). BPV parameters (SBPSD, SBPmax–min, SBPCV) were higher in the intensive SBP target group. Only DBP BPV parameters were associated with worse functional outcomes in the unadjusted model (DBPSD, DBPmax–min, DBPCV, and DBPSV), but not after adjustment. Higher SBPmax–min was associated with worse functional outcomes in Thrombolysis in Cerebral Infarction 2B patients (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.38–1.02), but not in patients with complete reperfusion (OR = 1.27, 95% CI = 0.80–2.02, p for heterogeneity (phet=0.037). None of the BPV parameters was associated with ICH, regardless of the randomization group or the reperfusion grade. Conclusions BPV was significantly higher in the intensive SBP target group but was not associated with functional outcome or ICH.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T05:29:32Z
2024-02-21T09:01:51Z
2024-02-21T09:01:51Z