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"Sudden Drop" in Blood Pressure is Associated With Recanalization After Thrombolysis.

Yan S, Liu K, Cao J, Liebeskind DS, Lou M - Medicine (Baltimore) (2015)

Bottom Line: We aim to investigate whether the phenomenon of "sudden drop" in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT).BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.We observed the phenomenon of "sudden drop" in systolic BP (≥20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment.This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.085-4.062; P = 0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension.The phenomenon of "sudden drop" in systolic BP with 20 mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (SY, KL, JC, ML), Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; and University of California-Los Angeles Stroke Center (DSL), Los Angeles, California.

ABSTRACT
We aim to investigate whether the phenomenon of "sudden drop" in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT). BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.We observed the phenomenon of "sudden drop" in systolic BP (≥20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment. This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.085-4.062; P = 0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension.The phenomenon of "sudden drop" in systolic BP with 20 mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion.

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Related in: MedlinePlus

Distribution of the first episode of “sudden drop.” Timing of the first episode of “sudden drop” in systolic blood pressure during the first 2 hours after intravenous thrombolysis.
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Figure 1: Distribution of the first episode of “sudden drop.” Timing of the first episode of “sudden drop” in systolic blood pressure during the first 2 hours after intravenous thrombolysis.

Mentions: For general definition, 15 (18.3%) patients had 2 “sudden drop” in BP with 20 mm Hg or greater and 2 patients had 3 episodes, while 65 (79.3%) only had 1 “sudden drop” in BP. The distribution of this phenomenon during the first 2 hours from the start of rtPA therapy was shown in Figure 1. The predictive ability increased, when only one episode of “sudden drop” was used to predict recanalization (area under the curve [AUC] = 0.611, P = 0.015, for All; AUC = 0.626, P = 0.010, for ICA or MCA; AUC = 0.666,Pp = 0.003, for MCA).


"Sudden Drop" in Blood Pressure is Associated With Recanalization After Thrombolysis.

Yan S, Liu K, Cao J, Liebeskind DS, Lou M - Medicine (Baltimore) (2015)

Distribution of the first episode of “sudden drop.” Timing of the first episode of “sudden drop” in systolic blood pressure during the first 2 hours after intravenous thrombolysis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554120&req=5

Figure 1: Distribution of the first episode of “sudden drop.” Timing of the first episode of “sudden drop” in systolic blood pressure during the first 2 hours after intravenous thrombolysis.
Mentions: For general definition, 15 (18.3%) patients had 2 “sudden drop” in BP with 20 mm Hg or greater and 2 patients had 3 episodes, while 65 (79.3%) only had 1 “sudden drop” in BP. The distribution of this phenomenon during the first 2 hours from the start of rtPA therapy was shown in Figure 1. The predictive ability increased, when only one episode of “sudden drop” was used to predict recanalization (area under the curve [AUC] = 0.611, P = 0.015, for All; AUC = 0.626, P = 0.010, for ICA or MCA; AUC = 0.666,Pp = 0.003, for MCA).

Bottom Line: We aim to investigate whether the phenomenon of "sudden drop" in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT).BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.We observed the phenomenon of "sudden drop" in systolic BP (≥20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment.This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.085-4.062; P = 0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension.The phenomenon of "sudden drop" in systolic BP with 20 mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neurology (SY, KL, JC, ML), Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; and University of California-Los Angeles Stroke Center (DSL), Los Angeles, California.

ABSTRACT
We aim to investigate whether the phenomenon of "sudden drop" in blood pressure (BP) within the first 2 hours is associated with vessel recanalization.We retrospectively examined clinical and imaging data from a consecutive series of patients with stroke with large vessel occlusion treated with intravenous thrombolysis (IVT). BP was monitored every 15 minutes during the first 2 hours, then every 30 minutes for 6 hours, and then every hour for 16 hours.We observed the phenomenon of "sudden drop" in systolic BP (≥20 mm Hg) in 82 (50.9%) patients in the first 2 hours and vessel recanalization in 87 (54.0%) patients 24 hours after treatment. This phenomenon was independently associated with recanalization (odds ratio 2.100; 95% confidence interval: 1.085-4.062; P = 0.028) after adjusting for the history of atrial fibrillation, coronary heart disease, and hypertension.The phenomenon of "sudden drop" in systolic BP with 20 mm Hg or greater between 2 continuous measurements within the first 2 hours is associated with recanalization after IVT in patients with large vessel occlusion, especially for middle cerebral artery occlusion.

Show MeSH
Related in: MedlinePlus