Abstract W P116: Association Between Blood Pressure And Short-Term Prognosis of Symptomatic Intracranial Atherosclerotic Stenosis

Abstract

Background and Purpose: Optimal blood pressure (BP) management for the patients with intracranial atherosclerotic stenosis (ICAS) has not been clearly defined. We investigated whether BP parameters during poststroke 7 months would affect the prognosis of symptomatic ICAS. Methods: Patients with acute symptomatic stenosis in the middle cerebral artery or the basilar artery were enrolled in Trial of cilOstazol in Symptomatic intracranial Stenosis 2 (TOSS-2). We included patients whose BP were measured 5 time points at baseline, 1, 3, 5 and 7 months during trial. Mean, maximum, maximum-minimum, standard deviation (SD), and coefficient of variation (CV) of systolic BP (SBP) and diastolic BP (DBP) were determined. The progression of symptomatic ICAS and the occurrence of new MRI lesions were investigated as the primary outcome by 7-month follow-up MR angiogram and MRI. Results: Of the 409 participants in TOSS-2 trial, 50 patients were excluded due to insufficient blood pressure value. Comparing 48 patients with the progression of symptomatic ICAS with 311 nonprogression group, no difference in mean SBP was observed. Values of maximum, maximum-minimum, SD and CV of SBP and DBP were not different between two groups either. All BP parameters were not different regarding the presence of new ischemic lesions on follow-up MRI. Patients with mean SBP below and above 140 mmHg during trials did not show different results in primary outcome (ICAS progression 11.6% vs. 17.6%, p=0.123; new MRI lesions 13.8% vs. 14.5%, p=0.890). Multivariable analysis revealed no specific BP parameters for the progression of ICAS or new ischemic MRI lesions during 7 months. Conclusions: No specific BP parameters were associated with the progression of ICAS and new lesion development on MRI during 7 months after stroke. Otherwise, no additional risks were noted in patients with symptomatic ICAS by mean BP below 140 mmHg.