20. Effect of Successive Systolic Blood Pressure Variability Following Intravenous Thrombolysis in Acute Ischemic Stroke – A Systematic Review and Meta-Analysis

Abstract

Background: Previous studies have shown contradictory findings regarding the effects of systolic blood pressure variability (SBPV) after intravenous thrombolysis (IVT) on functional outcomes and risk of intracranial hemorrhage (ICH) in acute ischemic stroke (AIS). Objective: The purpose of this systematic review and meta-analysis was to ascertain how SBPV indices, successive variance of SBPV (SPBVsv), following IVT affected the outcome in AIS. Method: We searched for articles published before October 2022 in the following databases: PubMed, Scopus, ScienceDirect, and ProQuest. The pooled multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using Jeffrey's Amazing Statistics Program (JASP). The outcomes included favorable functional result using modified Rankin Scale (mRS) score less than 2 within 90 days and intracranial hemorrhage event within 36 hours after IVT. The Newcastle Ottawa Scale (NOS) was used to rate the reliability of the studies. Result: Initial search revealed 2089 studies, of which 8 studies including 31791 patients with AIS and underwent IVT met the inclusion criteria. Increased of SBPVsv following IVT was substantially related with a poorer functional result in AIS (OR = 2.72, 95% CI 1.38 to 5.36, I2 = 93.8%, p value of Q test 0.004) and increase risk of ICH (OR = 1.46, 95% CI 1.01 to 2.12, I2 = 73.6%, p value of Q test 0.043) Conclusion: Successive systolic blood pressure variability has a negative relationship with 90-days outcome in AIS patients who received IVT while the risk of ICH within 36 hours after IVT is increase.