Pulse pressure variability is associated with unfavorable
outcomes in acute ischaemic stroke patients treated with
intravenous thrombolysis

J 2020

Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis

KATSANOS, A. H., A. V. ALEXANDROV, P. MANDAVA, M. KOHRMANN, L. SOINNE et. al.

Základní údaje

Originální název

Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis

Autoři

KATSANOS, A. H. (124 Kanada), A. V. ALEXANDROV (840 Spojené státy), P. MANDAVA (840 Spojené státy), M. KOHRMANN (276 Německo), L. SOINNE (246 Finsko), A. D. BARRETO (840 Spojené státy), V. K. SHARMA (702 Singapur), Robert MIKULÍK (203 Česká republika, domácí), K. W. MUIR (826 Velká Británie a Severní Irsko), T. ROTHLISBERGER (840 Spojené státy), J. C. GROTTA (840 Spojené státy), C. R. LEVI (36 Austrálie), C. A. MOLINA (724 Španělsko), M. SAQQUR (124 Kanada), L. PALAIODIMOU (300 Řecko), T. PSALTOPOULOU (300 Řecko), M. R. VOSKO (40 Rakousko), T. MOREIRA (752 Švédsko), J. B. FIEBACH (276 Německo), M. RUBIERA (724 Španělsko), E. C. SANDSET (578 Norsko), A. DE HAVENON (840 Spojené státy), T. A. KENT (840 Spojené státy), A. W. ALEXANDROV (840 Spojené státy), P. D. SCHELLINGER (276 Německo) a G. TSIVGOULIS (300 Řecko, garant)

Vydání

European Journal of Neurology, Oxford, Rapid Science Ltd. 2020, 1351-5101

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30103 Neurosciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 6.089

Kód RIV

RIV/00216224:14110/20:00116375

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1111/ene.14447

UT WoS

000559990700001

Klíčová slova anglicky

blood pressure; intracranial hemorrhage; outcome; pulse pressure; sonothrombolysis; stroke; thrombolysis; variability

Štítky

14110127, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 24. 11. 2020 12:24, Mgr. Tereza Miškechová

Anotace

V originále

Background and purpose Blood pressure (BP) variability has been associated with worse neurological outcomes in acute ischaemic stroke (AIS) patients receiving treatment with intravenous thrombolysis (IVT). However, no study to date has investigated whether pulse pressure (PP) variability may be a superior indicator of the total cardiovascular risk, as measured by clinical outcomes. Methods Pulse pressure variability was calculated from 24-h PP measurements following tissue plasminogen activator bolus in AIS patients enrolled in the Combined Lysis of Thrombus using Ultrasound and Systemic Tissue Plasminogen Activator for Emergent Revascularization (CLOTBUST-ER) trial. The outcomes of interest were the pre-specified efficacy and safety end-points of CLOTBUST-ER. All associations were adjusted for potential confounders in multivariable regression models. Results Data from 674 participants was analyzed. PP variability was identified as the BP parameter with the most parsimonious fit in multivariable models of all outcomes, and was independently associated (P < 0.001) with lower likelihood of both 24-h neurological improvement and 90-day independent functional outcome. PP variability was also independently related to increased odds of any intracranial bleeding (P = 0.011) and 90-day mortality (P < 0.001). Every 5-mmHg increase in the 24-h PP variability was independently associated with a 36% decrease in the likelihood of 90-day independent functional outcome (adjusted odds ratio 0.64, 95% confidence interval 0.52-0.80) and a 60% increase in the odds of 90-day mortality (adjusted odds ratio 1.60, 95% confidence interval 1.23-2.07). PP variability was not associated with symptomatic intracranial bleeding at either 24 or 36 h after IVT administration. Conclusions Increased PP variability appears to be independently associated with adverse short-term and long-term functional outcomes of AIS patients treated with IVT.

Citovat

KATSANOS, A. H., A. V. ALEXANDROV, P. MANDAVA, M. KOHRMANN, L. SOINNE, A. D. BARRETO, V. K. SHARMA, Robert MIKULÍK, K. W. MUIR, T. ROTHLISBERGER, J. C. GROTTA, C. R. LEVI, C. A. MOLINA, M. SAQQUR, L. PALAIODIMOU, T. PSALTOPOULOU, M. R. VOSKO, T. MOREIRA, J. B. FIEBACH, M. RUBIERA, E. C. SANDSET, A. DE HAVENON, T. A. KENT, A. W. ALEXANDROV, P. D. SCHELLINGER a G. TSIVGOULIS. Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis. European Journal of Neurology. Oxford: Rapid Science Ltd., 2020, roč. 27, č. 12, s. 2453-2462. ISSN 1351-5101. Dostupné z: https://dx.doi.org/10.1111/ene.14447.

@article{1677981,
   author = {Katsanos, A. H. and Alexandrov, A. V. and Mandava, P. and Kohrmann, M. and Soinne, L. and Barreto, A. D. and Sharma, V. K. and Mikulík, Robert and Muir, K. W. and Rothlisberger, T. and Grotta, J. C. and Levi, C. R. and Molina, C. A. and Saqqur, M. and Palaiodimou, L. and Psaltopoulou, T. and Vosko, M. R. and Moreira, T. and Fiebach, J. B. and Rubiera, M. and Sandset, E. C. and de Havenon, A. and Kent, T. A. and Alexandrov, A. W. and Schellinger, P. D. and Tsivgoulis, G.},
   article_location = {Oxford},
   article_number = {12},
   doi = {http://dx.doi.org/10.1111/ene.14447},
   keywords = {blood pressure; intracranial hemorrhage; outcome; pulse pressure; sonothrombolysis; stroke; thrombolysis; variability},
   language = {eng},
   issn = {1351-5101},
   journal = {European Journal of Neurology},
   title = {Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis},
   url = {https://onlinelibrary.wiley.com/doi/full/10.1111/ene.14447},
   volume = {27},
   year = {2020}
}

TY  - JOUR
ID  - 1677981
AU  - Katsanos, A. H. - Alexandrov, A. V. - Mandava, P. - Kohrmann, M. - Soinne, L. - Barreto, A. D. - Sharma, V. K. - Mikulík, Robert - Muir, K. W. - Rothlisberger, T. - Grotta, J. C. - Levi, C. R. - Molina, C. A. - Saqqur, M. - Palaiodimou, L. - Psaltopoulou, T. - Vosko, M. R. - Moreira, T. - Fiebach, J. B. - Rubiera, M. - Sandset, E. C. - de Havenon, A. - Kent, T. A. - Alexandrov, A. W. - Schellinger, P. D. - Tsivgoulis, G.
PY  - 2020
TI  - Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis
JF  - European Journal of Neurology
VL  - 27
IS  - 12
SP  - 2453-2462
EP  - 2453-2462
PB  - Rapid Science Ltd.
SN  - 13515101
KW  - blood pressure
KW  - intracranial hemorrhage
KW  - outcome
KW  - pulse pressure
KW  - sonothrombolysis
KW  - stroke
KW  - thrombolysis
KW  - variability
UR  - https://onlinelibrary.wiley.com/doi/full/10.1111/ene.14447
L2  - https://onlinelibrary.wiley.com/doi/full/10.1111/ene.14447
N2  - Background and purpose Blood pressure (BP) variability has been associated with worse neurological outcomes in acute ischaemic stroke (AIS) patients receiving treatment with intravenous thrombolysis (IVT). However, no study to date has investigated whether pulse pressure (PP) variability may be a superior indicator of the total cardiovascular risk, as measured by clinical outcomes. Methods Pulse pressure variability was calculated from 24-h PP measurements following tissue plasminogen activator bolus in AIS patients enrolled in the Combined Lysis of Thrombus using Ultrasound and Systemic Tissue Plasminogen Activator for Emergent Revascularization (CLOTBUST-ER) trial. The outcomes of interest were the pre-specified efficacy and safety end-points of CLOTBUST-ER. All associations were adjusted for potential confounders in multivariable regression models. Results Data from 674 participants was analyzed. PP variability was identified as the BP parameter with the most parsimonious fit in multivariable models of all outcomes, and was independently associated (P < 0.001) with lower likelihood of both 24-h neurological improvement and 90-day independent functional outcome. PP variability was also independently related to increased odds of any intracranial bleeding (P = 0.011) and 90-day mortality (P < 0.001). Every 5-mmHg increase in the 24-h PP variability was independently associated with a 36% decrease in the likelihood of 90-day independent functional outcome (adjusted odds ratio 0.64, 95% confidence interval 0.52-0.80) and a 60% increase in the odds of 90-day mortality (adjusted odds ratio 1.60, 95% confidence interval 1.23-2.07). PP variability was not associated with symptomatic intracranial bleeding at either 24 or 36 h after IVT administration. Conclusions Increased PP variability appears to be independently associated with adverse short-term and long-term functional outcomes of AIS patients treated with IVT.
ER  -

KATSANOS, A. H., A. V. ALEXANDROV, P. MANDAVA, M. KOHRMANN, L. SOINNE, A. D. BARRETO, V. K. SHARMA, Robert MIKULÍK, K. W. MUIR, T. ROTHLISBERGER, J. C. GROTTA, C. R. LEVI, C. A. MOLINA, M. SAQQUR, L. PALAIODIMOU, T. PSALTOPOULOU, M. R. VOSKO, T. MOREIRA, J. B. FIEBACH, M. RUBIERA, E. C. SANDSET, A. DE HAVENON, T. A. KENT, A. W. ALEXANDROV, P. D. SCHELLINGER a G. TSIVGOULIS. Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis. \textit{European Journal of Neurology}. Oxford: Rapid Science Ltd., 2020, roč.~27, č.~12, s.~2453-2462. ISSN~1351-5101. Dostupné z: https://dx.doi.org/10.1111/ene.14447.

Podrobný výpis o publikaci