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  • 11
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    Abstract TP308: Reduced Estimated Glomerular Filtration Rate And Outcomes Of Intracerebral Hemorrhage: The SAMURAI-ICH Study
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Background and Purpose: The association between chronic kidney disease and clinical outcomes in acute intracerebral hemorrhage (ICH) remains uncertain. We aimed to assess associations of renal dysfunction and outcomes in acute ICH patients treated with intensive BP lowering. Methods: The SAMURAI-ICH study was a prospective, multicenter, observational study. A total of 211 patients with acute supratentorial ICH were recruited. BP was targeted between 120 mmHg and 160 mmHg during initial 24 h using intravenous nicardipine. Glomerular filtration rate (eGFR) was calculated using admission serum creatinine. After 23 patients on maintenance hemodialysis were excluded, the remaining 188 were divided into 3 groups as follows: Group 1, eGFR of 〈 60; Group 2, 60 to 75; and Group 3, ≥75 mL/min/1.73m 2 . Clinical outcomes were hematoma expansion of ≥33% at 24 h, neurological deterioration within 72 h (GCS decrement ≥2 points or NIHSS increment ≥4 points), and favorable (modified Rankin Scale [mRS] ≤2) and unfavorable (mRS ≥5) outcomes at 3 months. Results: Of 188 patients, 35 (18 women) were allocated to Group 1, 58 (20) to Group 2, and 95 (33) to Group 3. Significant differences among 3 groups were found in age (73.1±13.6, 63.3±13.2, 63.8±9.8 yo; p 〈 0.001) and initial systolic BP (208.9±18.1, 201.2±15.6, 200.2±14.8 mmHg; p=0.018). Initial hematoma volume (14.9±11.9, 15.5±14.9, 14.3±12.3 mL) and initial median NIHSS score (14, 11, 13) were similar among 3 groups. For outcomes, significant differences among 3 groups were found in favorable outcome (17.7%, 51.7%, 41.3%; p=0.004) and unfavorable outcome (22.9%, 10.3%, 5.3%; p=0.021), but not in hematoma expansion (17.1%, 10.3%, 22.1%) and neurological deterioration (11.4%, 8.6%, 7.4%). After adjustment with initial hematoma volume, initial systolic BP and initial NIHSS score, eGFR 〈 60 ml/min/1.73m 2 was inversely associated with favorable outcome (OR 0.20, 95% CI 0.07-0.54) and positively associated with unfavorable outcome (4.27, 1.36-13.53). Conclusions: Although decreased eGFR on admission was not associated with initial hematoma volume or initial NIHSS score, it was associated with poor outcomes at 3 months of ICH onset.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.ATP308
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
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  • 12
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    Abstract 2642: The Impact of Chronic Kidney Disease on Carotid Atherosclerosis in a General Japanese Urban Population: the Suita Study
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Abstract: Introduction: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease and stroke. However, few studies have examined the association between CKD and carotid atherosclerosis as a subclinical study in general populations. We hypothesized that CKD was a strong predictor for carotid atherosclerosis and the predictive power was more accentuated with higher blood pressure (BP). Methods: Study participants (35 to 93 years of age; 1,844 women and 1,602 men) who gave written informed consent were randomly selected from a general urban population. Carotid atherosclerosis was evaluated by high-resolution ultrasonography (7.5MHz). Max-IMT was defined as the maximum IMT in the entire scanned area. Stenosis was defined as a condition in which a plaque occupied ≥25% of the lumen circumference of an artery on a cross-sectional scan. Glomerular filtration rate (GFR) [mL/min/1.73m 2 ] was estimated using the Modification of Diet in Renal Disease study equation and subjects were divided into 4 categories according to GFR (≥90, 60 to 89, 50 to 59, and 〈 50 mL/min/1.73m 2 ). CKD was defined as an estimated GFR 〈 60 mL/min/1.73m 2 . BP category (optimal, normal, and high-normal BP, and hypertension) was defined on the basis of the ESH-ESC 2007 criteria. The association of GFR category with the carotid atherosclerosis index and the impact of BP category on the index in the subjects with and without CKD were investigated by logistic regression analysis adjusting for confounding factors. Results: CKD was identified in 13.2% (16.2% for men and 10.5% for women). Compared with the subjects for GFR ≥90, the Max-IMT was significantly greater and the prevalence of stenosis was significantly higher (OR 1.91, 95% CIs 1.16 to 3.14) in the subjects with GFR 〈 50. As for the impact of BP category on carotid atherosclerosis, multivariable-adjusted Max-IMTs in subjects with hypertension were significantly greater than in those with optimal BP. This result was more evident in CKD subjects, especially in women. The impact of high-normal BP and hypertension on stenosis were more evident in subjects with CKD (ORs [95% CIs]: 1.58 [1.08 to 2.31] in non-CKD/high-normal BP, 2.74 [1.63 to 4.61] in CKD/high-normal BP, 1.94 [1.36 to 2.77] in non-CKD/hypertension, and 2.36 [1.49 to 3.73] in CKD/hypertension vs. non-CKD/optimal BP as a reference). Conclusions: CKD was associated with an increased risk for carotid atherosclerosis in a general urban Japanese population. Furthermore, the association between BP and carotid atherosclerosis may be evident by CKD. To prevent the carotid atherosclerosis, it is necessary for subjects with CKD to control their BP by lifestyle modification and proper clinical treatment.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A2642
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
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  • 13
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    Systolic Blood Pressure After Intravenous Antihypertensive Treatment and Clinical Outcomes in Hyperacute Intracerebral Hemorrhage : The Stroke Acute Management With Urgent Risk-Factor Assessment and Improvement-Intracerebral Hemorrhage Study
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. 7 ( 2013-07), p. 1846-1851
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 7 ( 2013-07), p. 1846-1851
    Abstract: Blood pressure (BP) lowering is often conducted as part of general acute management in patients with acute intracerebral hemorrhage. However, the relationship between BP after antihypertensive therapy and clinical outcomes is not fully known. Methods— Hyperacute ( 〈 3 hours from onset) intracerebral hemorrhage patients with initial systolic BP (SBP) 〉 180 mm Hg were included. All patients received intravenous antihypertensive treatment, based on predefined protocol to lower and maintain SBP between 120 and 160 mm Hg. BPs were measured every 15 minutes during the initial 2 hours and every 60 minutes in the next 22 hours (a total of 30 measurements). The mean achieved SBP was defined as the mean of 30 SBPs, and associations between the mean achieved SBP and neurological deterioration (≥2 points’ decrease in Glasgow Coma Score or ≥4 points’ increase in National Institutes of Health Stroke Scale score), hematoma expansion ( 〉 33% increase), and unfavorable outcome (modified Rankin Scale score 4–6 at 3 months) were assessed with multivariate logistic regression analyses. Results— Of the 211 patients (81 women, median age 65 [interquartile range, 58–74] years, and median initial National Institutes of Health Stroke Scale score 13 [8–17] ) enrolled, 17 (8%) showed neurological deterioration, 36 (17%) showed hematoma expansion, and 87 (41%) had an unfavorable outcome. On multivariate regression analyses, mean achieved SBP was independently associated with neurological deterioration (odds ratio, 4.45; 95% confidence interval, 2.03–9.74 per 10 mm Hg increment), hematoma expansion (1.86; 1.09–3.16), and unfavorable outcome (2.03; 1.24–3.33) after adjusting for known predictive factors. Conclusions— High achieved SBP after standardized antihypertensive therapy in hyperacute intracerebral hemorrhage was independently associated with poor clinical outcomes. Aggressive antihypertensive treatment may ameliorate clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.113.001212
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
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  • 14
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    Abstract 2882: The Combined Impact of Glucose Abnormality and Blood Pressure Category on Carotid Atherosclerosis in a General Urban Japanese Population: The Suita Study
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Stroke Vol. 43, No. suppl_1 ( 2012-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. suppl_1 ( 2012-02)
    Abstract: Introduction: Diabetes Mellitus (DM) and hypertension (HT) have been proven to be risk factors for cardiovascular diseases and stroke. However, few studies have examined the relationships of carotid artery intima-media thickness (IMT) with combination of glucose abnormality and blood pressure (BP) categories in a general population. We assessed the hypothesis that the effect of the risks of these factors on carotid atherosclerosis was more accentuated with combination of higher categories on glucose and BP in a general urban Japanese population. Methods: Participants (35-93 years of age; 1,844 women and 1,602 men) who gave written informed consent were randomly selected from a general urban population (between 2002 and 2004). Carotid atherosclerosis was evaluated by high-resolution ultrasonography (7.5MHz) with atherosclerotic indexes of IMT in the common carotid artery (CCA), carotid artery bulb (Bulb), and internal and external carotid arteries. Mean IMT was defined as the mean of the IMT of the proximal and distal walls for both sides of the CCA at a point 10 mm proximal to the beginning of the dilation of each Bulb. Maximum IMT was assessed in the entire scanned area. Stenosis ( 〉 =25%) was defined as a condition in which a plaque occupied more than 25% of the lumen circumference of an artery on a cross-sectional scan. Serum glucose categories (normoglycemia, impaired fasting glucose [IFG] and DM) were defined according to the 2003 ADA recommendations. BP categories (optimal, normal, high-normal BP and HT) were defined on the basis of the ESH-ESC 2007 criteria. The association of serum glucose categories with the carotid atherosclerotic indexes was investigated through logistic regression analysis considering potential confounding risk variables including BP category. Results: Compared with normoglycemic subjects, the mean and maximum IMTs were significantly greater in women with DM (mean: 0.836 vs 0.802 p=0.001, maximum: 1.370 vs 1.205 p 〈 0.001) and in men with IFG (mean: 0.858 vs 0.838 p=0.004, maximum: 1.511 vs 1.439 p=0.038) and DM (mean: 0.885 vs 0.838 p 〈 0.001, maximum: 1.631 vs 1.439 p 〈 0.001). Compared with normoglycemic subjects, the odds ratios (OR) (95% confidence intervals [CI]) for stenosis was 1.67 (1.22-2.30) in subjects with DM. Compared with optimal BP subjects, the OR (95% CI) for stenosis was 1.52 (1.15-2.01) in subjects with HT. In combination, the OR for stenosis with optimal, normal, high-normal BP and HT were 1(reference), 1.96, 2.48 and 2.71 with normoglycemia, 1.99, 1.83, 2.26 and 2.88 with IFG and 7.04, 2.18, 3.42 and 4.09 with DM (P-value for interaction=0.049). Conclusion: Compared with normoglycemic subjects, the mean and maximum IMTs were significantly greater in women with DM and in men with IFG and DM and stenosis was significantly greater in subjects with DM. The impact of each glucose category on the stenosis was more evident in subjects with a higher BP category.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.43.suppl_1.A2882
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
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  • 15
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    Magnetic Resonance Imaging–Guided Thrombolysis (0.6 mg/kg) Was Beneficial for Unknown Onset Stroke Above a Certain Core Size : THAWS RCT Substudy
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 1 ( 2021-01), p. 12-19
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 1 ( 2021-01), p. 12-19
    Abstract: We determined to identify patients with unknown onset stroke who could have favorable 90-day outcomes after low-dose thrombolysis from the THAWS (Thrombolysis for Acute Wake-Up and Unclear-Onset Strokes With Alteplase at 0.6 mg/kg) database. Methods: This was a subanalysis of an investigator-initiated, multicenter, randomized, open-label, blinded–end point trial. Patients with stroke with a time last-known-well 〉 4.5 hours who showed a mismatch between diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery were randomly assigned (1:1) to receive alteplase at 0.6 mg/kg intravenously or standard medical treatment. The patients were dichotomized by ischemic core size or National Institutes of Health Stroke Scale score, and the effects of assigned treatments were compared in each group. The efficacy outcome was favorable outcome at 90 days, defined as a modified Rankin Scale score of 0 to 1. Results: The median DWI-Alberta Stroke Program Early CT Score (ASPECTS) was 9, and the median ischemic core volume was 2.5 mL. Both favorable outcome (47.1% versus 48.3%) and any intracranial hemorrhage (26% versus 14%) at 22 to 36 hours were comparable between the 68 thrombolyzed patients and the 58 control patients. There was a significant treatment-by-cohort interaction for favorable outcome between dichotomized patients by ASPECTS on DWI ( P =0.026) and core volume ( P =0.035). Favorable outcome was more common in the alteplase group than in the control group in patients with DWI-ASPECTS 5 to 8 (RR, 4.75 [95% CI, 1.33–30.2]), although not in patients with DWI-ASPECTS 9 to 10. Favorable outcome tended to be more common in the alteplase group than in the control group in patients with core volume 〉 6.4 mL (RR, 6.15 [95% CI, 0.87–43.64]), although not in patients with volume ≤6.4 mL. The frequency of any intracranial hemorrhage did not differ significantly between the 2 treatment groups in any dichotomized patients. Conclusions: Patients developing unknown onset stroke with DWI-ASPECTS 5 to 8 showed favorable outcomes more commonly after low-dose thrombolysis than after standard treatment. Registration: URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02002325. URL: https://www.umin.ac.jp/ctr ; Unique Identifier: UMIN000011630.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.030848
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 16
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    Blood Pressure Level and Variability During Long-Term Prasugrel or Clopidogrel Medication After Stroke : PRASTRO-I
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 4 ( 2021-04), p. 1234-1243
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 4 ( 2021-04), p. 1234-1243
    Abstract: High blood pressure increases bleeding risk during treatment with antithrombotic medication. The association between blood pressure levels and the risk of recurrent stroke during long-term secondary stroke prevention with thienopyridines (particularly prasugrel) has not been well studied. Methods: This was a post hoc analysis of the randomized, double-blind, multicenter PRASTRO-I trial (Comparison of Prasugrel and Clopidogrel in Japanese Patients With Ischemic Stroke-I). Patients with noncardioembolic stroke were randomly assigned (1:1) to receive prasugrel 3.75 mg/day or clopidogrel 75 mg/day for 96 to 104 weeks. Risks of any ischemic or hemorrhagic stroke, combined ischemic events, and combined bleeding events were determined based on the mean level and visit-to-visit variability, including successive variation, of systolic blood pressure (SBP) throughout the observational period. These risks were also compared between quartiles of mean SBP level and successive variation of SBP. Results: A total of 3747 patients (age 62.1±8.5 years, 797 women), with a median average SBP level during the observational period of 132.5 mm Hg, were studied. All the risks of any stroke (146 events; hazard ratio, 1.318 [95% CI, 1.094–1.583] per 10-mm Hg increase), ischemic stroke (133 events, 1.219 [1.010–1.466] ), hemorrhagic stroke (13 events, 3.247 [1.660–6.296]), ischemic events (142 events, 1.219 [1.020–1.466] ), and bleeding events (47 events, 1.629 [1.172–2.261]) correlated with increasing mean SBP overall. Similarly, an increased risk of these events correlated with increasing successive variation of SBP (hazard ratio, 3.078 [95% CI, 2.220–4.225] per 10-mm Hg increase; 3.051 [2.179–4.262]; 3.276 [1.172–9.092] ; 2.865 [2.042–4.011]; 2.764 [1.524–5.016] , respectively). Event rates did not differ between the clopidogrel and prasugrel groups within each quartile of SBP or successive variation of SBP. Conclusions: Both high mean SBP level and high visit-to-visit variability in SBP were significantly associated with the risk of recurrent stroke during long-term medication with either prasugrel or clopidogrel after stroke. Control of hypertension would be important regardless of the type of antiplatelet drugs. Registration: URL: https://www.clinicaltrials.jp ; Unique identifier: JapicCTI-111582.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.032824
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 17
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    Early Neurological Deterioration within 24 Hours after Intravenous rt-PA Therapy for Stroke Patients: The Stroke Acute Management with Urgent Risk Factor Assessment and Improvement rt-PA Registry
    S. Karger AG ; 2012
    In:  Cerebrovascular Diseases Vol. 34, No. 2 ( 2012), p. 140-146
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 34, No. 2 ( 2012), p. 140-146
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The initial 24 h after thrombolysis are critical for patients’ conditions, and continuous neurological assessment and blood pressure measurement are required during this time. The goal of this study was to identify the clinical factors associated with early neurological deterioration (END) within 24 h of stroke patients receiving intravenous recombinant tissue plasminogen activator (rt-PA) therapy and to clarify the effect of END on 3-month outcomes. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A retrospective, multicenter, observational study was conducted in 10 stroke centers in Japan. A total of 566 consecutive stroke patients [211 women, 72 ± 12 years old, the median initial NIH Stroke Scale (NIHSS) score of 13] treated with intravenous rt-PA (0.6 mg/kg alteplase) was studied. END was defined as a 4-point or greater increase in the NIHSS score at 24 h from the NIHSS score just before thrombo lysis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 END was present in 56 patients (9.9%, 18 women, 72 ± 10 years old) and was independently associated with higher blood glucose [odds ratio (OR) 1.17, 95% confidence intervals (CI) 1.07–1.28 per 1 mmol/l increase, p 〈 0.001], lower initial NIHSS score (OR 0.92, 95% CI 0.87–0.97 per 1-point increase, p = 0.002), and internal carotid artery (ICA) occlusion (OR 5.36, 95% CI 2.60–11.09, p 〈 0.001) on multivariate analysis. Symptomatic intracranial hemorrhage within the initial 36 h from thrombolysis was more common in patients with END than in the other patients (per NINDS/Cochrane protocol, OR 10.75, 95% CI 4.33–26.85, p 〈 0.001, and per SITS-MOST protocol, OR 12.90, 95% CI 2.76–67.41, p = 0.002). At 3 months, no patients with END had a modified Rankin Scale (mRS) score of 0–1. END was independently associated with death and dependency (mRS 3–6, OR 20.44, 95% CI 6.96–76.93, p 〈 0.001), as well as death (OR 19.43, 95% CI 7.75–51.44, p 〈 0.001), at 3 months. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Hyperglycemia, 〈 b 〉 〈 /b 〉 lower baseline NIHSS score, and ICA occlusion were independently associated with END after rt-PA therapy. END was independently associated with poor 3-month stroke outcome after rt-PA therapy.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000339759
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
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  • 18
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    Abstract TP227: Three-dimensional Analysis Of Flow, Volume And Ejection Fraction Of The Left Atrial Appendage In Acute Stroke Patients With Paroxysmal Atrial Fibrillation
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. suppl_1 ( 2013-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
    Abstract: Background and objective: Decreased peak flow velocity (PFV) of the left atrial appendage (LAA) measured by transesophageal echocardiography (TEE) was reported to be associated with atrial fibrillation (AF) and thrombus formation in LAA. This study aimed to elucidate the association between flow, volume and ejection fraction (EF) of LAA measured by real-time three dimensional TEE (3D-TEE) and the presence of paroxysmal atrial fibrillation (PAF) in acute stroke. Methods: 3D-TEE was performed using an iE 33 Ultrasound Machine and X7-2t TEE transducer (Philips Healthcare) in acute stroke patients with sinus rhythm at the examination. Patients were divided into those with a history or later documentation of PAF (PAF group) and others (sinus group). PFV was measured by pulse Doppler and LAA volume was measured off-line using QLAB software. LAA volume was measured twice before p wave (maximum LAA volume) and after p wave (minimum LAA volume) to calculate EF of LAA. Results: Of a total 97 patients (26 women, 72.7±10.6 years), 20 were allocated to the PAF group and the remaining 77 to the sinus group. LAA volume and EF were correlated with PFV (r=0.378, p=0.0002 and r = 0.374, p=0.0002; respectively). Patients in the PAF group had lower PFV (39.0cm/s, 29.4-57.0 vs. 63.9cm/s, 38.3-81.8, p=0.0006), larger LAA volume (median 7.6ml, IQR 3.6-10.45 vs. 2.3ml, 1.6-6.2, p=0.0033) and lower EF (38.2%, 21.4-49.8 vs. 58.1%, 44.1-71.8, p=0.0006) than those in the sinus group. Using receiver operating characteristic curve analysis, the optimal cutoff of PFV to predict PAF patients was ≤39cm/s, with a sensitivity of 58%, a specificity of 89%, and a c-statistic of 0.756. The cutoff of LAA volume was ≥7.5ml, with a sensitivity of 55%, a specificity of 84%, and a c-statistic of 0.714. The cutoff of EF was ≤47.9%, with a sensitivity of 75%, a specificity of 75%, and a c-statistic of 0.751. Using the combination of LAA volume ≥7.5ml or EF ≤47.9%, patients with PAF were detected with a sensitivity of 85% and a specificity of 67%. Conclusions: Because EF of LAA was associated with FV, it is a promising marker of LAA function. LAA enlargement and reduced LAA contraction, measured by 3-dimensional techniques, in addition to lower FV may help us to detect those with PAF in acute stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.44.suppl_1.ATP227
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
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  • 19
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    Impact of Early Blood Pressure Variability on Stroke Outcomes After Thrombolysis : The SAMURAI rt-PA Registry
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Stroke Vol. 44, No. 3 ( 2013-03), p. 816-818
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. 3 ( 2013-03), p. 816-818
    Abstract: The present study determines associations between early blood pressure (BP) variability and stroke outcomes after intravenous thrombolysis. Methods— In 527 stroke patients receiving intravenous alteplase (0.6 mg/kg), BP was measured 8 times within the first 25 hours. BP variability was determined as ΔBP (maximum-minimum), standard deviation (SD), coefficient of variation, and successive variation. Results— The systolic BP course was lower among patients with modified Rankin Scale (mRS) 0 to 1 than those without ( P 〈 0.001). Most of systolic BP variability profiles were significantly associated with outcomes. Adjusted odds ratios (95% confidence interval) per 10 mm Hg (or 10% for coefficient of variation) on symptomatic intracerebral hemorrhage were as follows: ΔBP, 1.33 (1.08–1.66); SD, 2.52 (1.26–5.12); coefficient of variation, 3.15 (1.12–8.84); and successive variation, 1.82 (1.04–3.10). The respective values were 0.88 (0.77–0.99), 0.73 (0.48–1.09), 0.77 (0.43–1.34), and 0.76 (0.56–1.03) for 3-month mRS 0 to 1; and 1.40 (1.14–1.75), 2.85 (1.47–5.65), 4.67 (1.78–12.6), and 1.99 (1.20–3.25) for death. Initial BP values before thrombolysis were not associated with any outcomes. Conclusions— Early systolic BP variability was positively associated with symptomatic intracerebral hemorrhage and death after intravenous thrombolysis.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.112.681007
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
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  • 20
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    Relative systolic blood pressure reduction and clinical outcomes in hyperacute intracerebral hemorrhage : the SAMURAI-ICH observational study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Journal of Hypertension Vol. 33, No. 5 ( 2015-05), p. 1069-1073
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 5 ( 2015-05), p. 1069-1073
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/HJH.0000000000000512
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2017684-3
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