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Blood Pressure Variability during Angiography in Patients with Ischemic Stroke and Intracranial Artery Stenosis
Hui Pan1,2, Rong Zhao1,2, Feng-Di Liu1,2
1Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
Insights
Blood pressure variability during cerebral angiography differs based on timing after ischemic stroke. Factors predicting blood pressure variability varied, but it was not linked to patient outcomes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Intracranial artery stenosis and ischemic stroke pose significant health risks.
- Blood pressure (BP) variability during diagnostic cerebral angiography is a potential concern.
- Understanding predictors and outcomes related to BP variability is crucial for patient management.
Purpose of the Study:
- To identify factors predicting BP variability during cerebral angiography in stroke patients.
- To examine the association between BP variability and clinical outcomes.
- To compare BP variability predictors based on the timing of angiography relative to stroke onset.
Main Methods:
- Retrospective analysis of 114 patients with ischemic stroke and >50% intracranial artery stenosis.
- Categorization into Group A (angiography within 3 days) and Group S (3-14 days).
- Regression analyses to determine BP variability predictors and outcome associations.
Main Results:
- Advanced age, male sex, and antihypertensive use were associated with BP variability in Group A.
- Hypertension, antihypertensive use, and male sex were linked to BP variability in Group S.
- Higher Stroke Scale scores predicted poor outcomes; BP variability did not.
Conclusions:
- Predictors of BP variability during cerebral angiography differ significantly based on the timing of the procedure post-stroke.
- BP variability was not found to be significantly associated with clinical outcomes at discharge in this patient cohort.
Abstract:
Our aim was to investigate factors predicting blood pressure (BP) variability during diagnostic cerebral angiography and associations between BP variability and clinical outcomes in patients with acute and subacute ischemic stroke and intracranial artery stenosis. 114 patients with ischemic stroke and intracranial artery stenosis (stenosis rate >50%) were recruited. Patients who underwent cerebral angiography within 3 days and 3-14 days of disease onset are referred to be Group A and Group S, respectively. BP variability in Group A was defined as the coefficient of variance (CV) of BP. Univariate and multivariate regression analyses were used to identify predictors of CV of BP and associations between CV of BP and clinical outcomes at discharge. In Group A patients, advanced age was associated with increased CV of SBP and diastolic blood pressure (DBP), and antihypertensive use was associated with lower CV of SBP. Male was associated with lower CV of DBP. In Group S, higher CV of SBP was associated with hypertension and antihypertensive use. Males had lower CV of SBP than females. The calcium channel blocker was associated with lower CV of DBP. Higher scores of the Stroke Scale at admission were significantly associated with poor clinical outcomes for both groups, while BP variability was not. Factors associated with BP variability are significantly different between stroke patients undergoing angiography within 3 days vs. 3-14 days after disease onset. BP variability is not significantly associated with clinical outcomes at discharge.
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