Time-dependent systolic blood pressure within 72h after endovascular treatment in large vessel occlusion stroke.

Abstract

The association of systolic blood pressure (SBP) and ischemic stroke outcome has recently been proved to be varied at different time points within 72h after acute ischemic stroke onset; however, the specific status of how SBP affects prognosis at different time points within 72h after endovascular treatment (EVT) among patients with large vessel occlusion (LVO) remains unclear. Consecutive LVO patients treated with EVT were enrolled in our study. BP data were collected at eight time points (1, 2, 4, 8, 16, 24, 48, and 72h post-EVT). Outcome measure of interest was functional dependence, which was defined as mRS >2 at 90 days. A total of 406 LVO patients treated with EVT from 2016 to 2022 were included. At 16h after EVT, the relationship between SBP and functional dependence showed a nonlinear association. At other time points after EVT, SBP had linear relationships with functional dependence. Furthermore, higher SBP, as either a linear or quadratic term, had an adverse effect on functional outcome. In addition, three SBP trajectories were observed, and the high-to-low group was independently associated with functional dependence. Taken together, higher SBP within the first 72h after EVT has a time-dependent association with adverse clinical outcomes. Optimal blood pressure management during the first 72h after EVT may be important to improve clinical outcome.