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@article{1758077, author = {Tsivgoulis, G. and Katsanos, A. H. 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 Mavridis, D. and Psaltopoulou, T. and Vosko, M. R. and Fiebach, J. B. and Sandset, E. C. and Kent, T. A. and Alexandrov, A. W. and Schellinger, P. D. and Alexandrov, A. V.}, article_location = {PHILADELPHIA}, article_number = {2}, doi = {http://dx.doi.org/10.1097/HJH.0000000000002628}, keywords = {blood pressure; intracranial hemorrhage; monitoring; outcome; sonothrombolysis; stroke; thrombolysis}, language = {eng}, issn = {0263-6352}, journal = {Journal of Hypertension}, title = {Blood pressure excursions in acute ischemic stroke patients treated with intravenous thrombolysis}, url = {https://journals.lww.com/jhypertension/Fulltext/2021/02000/Blood_pressure_excursions_in_acute_ischemic_stroke.11.aspx}, volume = {39}, year = {2021} }
TY - JOUR ID - 1758077 AU - Tsivgoulis, G. - Katsanos, A. H. - 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. - Mavridis, D. - Psaltopoulou, T. - Vosko, M. R. - Fiebach, J. B. - Sandset, E. C. - Kent, T. A. - Alexandrov, A. W. - Schellinger, P. D. - Alexandrov, A. V. PY - 2021 TI - Blood pressure excursions in acute ischemic stroke patients treated with intravenous thrombolysis JF - Journal of Hypertension VL - 39 IS - 2 SP - 266-272 EP - 266-272 PB - William and Wilkins SN - 02636352 KW - blood pressure KW - intracranial hemorrhage KW - monitoring KW - outcome KW - sonothrombolysis KW - stroke KW - thrombolysis UR - https://journals.lww.com/jhypertension/Fulltext/2021/02000/Blood_pressure_excursions_in_acute_ischemic_stroke.11.aspx N2 - Objective: To investigate the association of blood pressure BP excursions, defined as greater than 185 SBP or greater than 105 DBP, with the probability of intracranial hemorrhage (ICH) and worse functional outcomes in patients with acute ischemic stroke (AIS) treated with tissue plasminogen activator (tPA). Methods: We performed a post hoc analysis of the CLOTBUST-ER trial. Serial BP measurements were conducted using automated cuff recording according to the recommended BP protocol guidelines for tPA administration. The outcomes were prespecified efficacy and safety endpoints of CLOTBUST-ER. Results: The mean number of serial BP recordings per patient was 37. Of the 674 patients, 227 (34%) had at least one BP excursion (>185/105 mmHg) during the first 24 h following tPA-bolus. The majority of BP excursions (46%) occurred within the first 75min from tPA-bolus. Patients with at least one BP excursion in the first 24 h following tPA bolus had significantly lower rates of independent functional outcome at 90 days (31 vs. 40.1%, P = 0.028). The total number of BP excursions was associated with decreased odds of 24-h clinical recovery (OR = 0.88, 95% CI:0.80-0.96), 24-h neurological improvement (OR = 0.87, 95% CI: 0.81-0.94), 7-day functional improvement (common OR = 0.92, 95% CI: 0.87-0.97), 90-day functional improvement (common OR = 0.94, 95% CI: 0.88-0.98) and 90-day independent functional outcome (OR = 0.90, 95% CI: 0.82-0.98) in analyses adjusted for potential confounders. DBP excursions were independently associated with increased odds of any intracranial hemorrhage (OR = 1.26, 95% CI: 1.04-1.53). Conclusion: BP excursions above guideline thresholds during the first 24 h following tPA administration for AIS are common and are independently associated with adverse clinical outcomes. ER -
TSIVGOULIS, G., A. H. KATSANOS, 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, D. MAVRIDIS, T. PSALTOPOULOU, M. R. VOSKO, J. B. FIEBACH, E. C. SANDSET, T. A. KENT, A. W. ALEXANDROV, P. D. SCHELLINGER a A. V. ALEXANDROV. Blood pressure excursions in acute ischemic stroke patients treated with intravenous thrombolysis. \textit{Journal of Hypertension}. PHILADELPHIA: William and Wilkins, 2021, roč.~39, č.~2, s.~266-272. ISSN~0263-6352. Dostupné z: https://dx.doi.org/10.1097/HJH.0000000000002628.
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