Abstract TP390: The Prognosis of Adverse Stroke Outcomes on the Post IV Alteplase Ischemic Stroke Patients: A Trajectory Groups of 24-Hour Systolic Blood Pressure (SBP) Measurement

Abstract

Background: To explore whether longitudinal 24-hour SBP trajectory patterns after thrombolysis could predict the risk of adverse stroke outcome. Methods: The total of 362 ischemic stroke patients, were selected with onset of within 4.5 hours and underwent intravenous(IV) thrombolysis with alteplase(rt-PA). Group-based trajectory models to identify SBP subgroups were used. The demographics, medical history, laboratory test results and the stroke outcome including early neurological deterioration (END), early neurological improvement (ENI), hemorrhage, Barthel index(BI), the modified Rankin Scale (mRS) score, recurrent stroke at 3 months after stroke were collected. Results: The stroke patients with IV thrombolysis were classified into six SBP trajectory groups: admission SBP, antihypertensive drugs before thrombolysis, history of hypertension, stroke, hemoglobin, glucose, and triglycerides. There was no difference in the incidence of hemorrhage, END, and recurrent stroke. The results of logistic analysis,when compared with the moderate-stable SBP group, there was a negative correlation between the risk of ENI and SBP trajectory patterns (OR=0.32; 95%CI: 0.15 to 0.67) , and the “J” correlation between the risk of the mRS score(OR=0.31; 95%CI: 1.50 to 7.30). Conclusion: The findings potentially help identify candidates for clinical blood pressure observation, blood pressure control and nursing care and management.