The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study

Introduction. Reperfusion (both pharmacological and interventional) is the cornerstone of acute ischemic stroke (AIS) management. Currently, there are only limited data in the scientific literature regarding the influence of systemic hemodynamic parameters on the recanalization status and complicati...

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Published in:Food Processing: Techniques and Technology
Main Authors: A. R. Avidzba, V. A. Saskin, A. V. Kudryavtsev, M. Yu. Kirov, А. Р. Авидзба, В. А. Саскин, В. А. Кудрявцев, М. Ю. Киров
Other Authors: The financing was carried out at the expense of the grant of the Russian Science Foundation «Conducting fundamental scientific researches and exploratory scientific researches by small individual scientific groups». № 23-25-10070., Источники финансирования или иной поддержки. Финансирование осуществлялось за счет средств гранта Российского научного фонда «Проведение фундаментальных научных исследований и поисковых научных исследований малыми отдельными научными группами». № 23-25-10070.
Format: Article in Journal/Newspaper
Language:Russian
Published: NEW TERRA Publishing House 2023
Subjects:
артериальное давление
intravenous thrombolysis
arterial pressure
системный тромболизис
Arkhangelsk
Online Access:https://www.vair-journal.com/jour/article/view/896
https://doi.org/10.24884/2078-5658-2023-20-6-28-34
id ftjvair:oai:oai.vair.elpub.ru:article/896
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collection Messenger of ANESTHESIOLOGY AND RESUSCITATION
op_collection_id ftjvair
language Russian
topic артериальное давление
intravenous thrombolysis
arterial pressure
системный тромболизис
spellingShingle артериальное давление
intravenous thrombolysis
arterial pressure
системный тромболизис
A. R. Avidzba
V. A. Saskin
A. V. Kudryavtsev
M. Yu. Kirov
А. Р. Авидзба
В. А. Саскин
В. А. Кудрявцев
М. Ю. Киров
The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
topic_facet артериальное давление
intravenous thrombolysis
arterial pressure
системный тромболизис
description Introduction. Reperfusion (both pharmacological and interventional) is the cornerstone of acute ischemic stroke (AIS) management. Currently, there are only limited data in the scientific literature regarding the influence of systemic hemodynamic parameters on the recanalization status and complications of AIS.The objective of our study was to assess the relationship between the systemic hemodynamic parameters in the early postreperfusion period and the outcomes of AIS.Materials and methods. For retrospective analysis, data of 292 patients who received intravenous thrombolysis (IVT) at the Arkhangelsk Regional Stroke Center between 2010 and 2021 were collected. The main endpoints were functional outcome, mortality, and symptomatic intracranial hemorrhage (sICH). The success of reperfusion was defined as the neurological improvement by 4 or more points of the NIHSS score within the first 24 hours after the start of IVT.Results. The relationship between mean systolic blood pressure (SBP) during the first 24 hours of IVT and functional recovery was obtained: B = 0.016 (β = 0.096) [95 % CI 0.000 – 0.031] (р = 0.49). The relationship between maximal SBP during the first day of IVT and functional recovery was also determined: B = 0.009 (β = 0.102) [95 % CI 0.001 – 0.018] (p = 0.037). The sICH occurred in nine cases, all of them were in the group without achieving successful reperfusion.Conclusion. The baseline levels of SBP ≥ 160 mm Hg at hospital admission in patients with AIS followed by IVT are accompanied by worse functional outcome and greater odds of death. The neurological improvement with significant decline in the NIHSS score during the first 24 hours after IVT is associated with a decreased risk of sICH. Введение. Реперфузионные методики (как фармакологические, так и интервенционные) являются основой терапии ишемического инсульта (ИИ) в острейшем периоде. На текущий момент в научной литературе существуют только ограниченные данные о влиянии статуса реканализации на параметры системной гемодинамики и исходы ...
author2 The financing was carried out at the expense of the grant of the Russian Science Foundation «Conducting fundamental scientific researches and exploratory scientific researches by small individual scientific groups». № 23-25-10070.
Источники финансирования или иной поддержки. Финансирование осуществлялось за счет средств гранта Российского научного фонда «Проведение фундаментальных научных исследований и поисковых научных исследований малыми отдельными научными группами». № 23-25-10070.
format Article in Journal/Newspaper
author A. R. Avidzba
V. A. Saskin
A. V. Kudryavtsev
M. Yu. Kirov
А. Р. Авидзба
В. А. Саскин
В. А. Кудрявцев
М. Ю. Киров
author_facet A. R. Avidzba
V. A. Saskin
A. V. Kudryavtsev
M. Yu. Kirov
А. Р. Авидзба
В. А. Саскин
В. А. Кудрявцев
М. Ю. Киров
author_sort A. R. Avidzba
title The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
title_short The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
title_full The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
title_fullStr The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
title_full_unstemmed The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
title_sort influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study
publisher NEW TERRA Publishing House
publishDate 2023
url https://www.vair-journal.com/jour/article/view/896
https://doi.org/10.24884/2078-5658-2023-20-6-28-34
genre Arkhangelsk
genre_facet Arkhangelsk
op_source Messenger of ANESTHESIOLOGY AND RESUSCITATION; Том 20, № 6 (2023); 28-34
Вестник анестезиологии и реаниматологии; Том 20, № 6 (2023); 28-34
2541-8653
2078-5658
op_relation https://www.vair-journal.com/jour/article/view/896/674
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https://www.vair-journal.com/jour/article/view/896
doi:10.24884/2078-5658-2023-20-6-28-34
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spelling ftjvair:oai:oai.vair.elpub.ru:article/896 2024-01-14T10:05:16+01:00 The influence of systolic arterial pressure in the first day after systemic thrombolysis on ischemic stroke outcomes and complication rate: a retrospective single-center study Влияние показателей систолического артериального давления в первые сутки после системного тромболизиса на исходы ишемического инсульта и частоту осложнений: ретроспективное одноцентровое исследование A. R. Avidzba V. A. Saskin A. V. Kudryavtsev M. Yu. Kirov А. Р. Авидзба В. А. Саскин В. А. Кудрявцев М. Ю. Киров The financing was carried out at the expense of the grant of the Russian Science Foundation «Conducting fundamental scientific researches and exploratory scientific researches by small individual scientific groups». № 23-25-10070. Источники финансирования или иной поддержки. Финансирование осуществлялось за счет средств гранта Российского научного фонда «Проведение фундаментальных научных исследований и поисковых научных исследований малыми отдельными научными группами». № 23-25-10070. 2023-12-16 application/pdf https://www.vair-journal.com/jour/article/view/896 https://doi.org/10.24884/2078-5658-2023-20-6-28-34 rus rus NEW TERRA Publishing House https://www.vair-journal.com/jour/article/view/896/674 Ишемический инсульт и транзиторная ишемическая атака у взрослых: клинические рекомендации. – М.: Министерство здравоохранения Российской Федерации, 2021. URL: https://cr.minzdrav.gov.ru/schema/171_2 (accessed: 10.10.23). Скворцова В. И., Шетова И. М., Какорина Е. П. и др. Результаты реализации «Комплекса мероприятий по совершенствованию медицинской помощи пациентам с острыми нарушениями мозгового кровообращения в Российской Федерации» // Журнал неврологии и психиатрии им. С. С. Корсакова. – 2018. – Т. 4. – С. 5–12. DOI:10.17116/jnevro2018118415-12. Adams H. P., Bendixen B. H., Kappelle L. J. et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment // Stroke. – 1993. – Vol. 24, № 1. – P. 35–41. DOI:10.1161/01.str.24.1.35. Ahmed N., Wahlgren N., Brainin M. et al. Relationship of blood pressure, antihypertensive therapy, and outcome in ischemic stroke treated with intravenous thrombolysis: retrospective analysis from Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) // Stroke. – 2009. – Vol. 40, № 7. – P. 2442–2449. DOI:10.1161/STROKEAHA.109.548602. Albers G., Bates V., Clark W. et al. Intravenous tissue-type plasminogen activator for treatment of acute stroke: the standard treatment with alteplase to reverse stroke (STARS) study // JAMA J Am Med Assoc. – 2000. – Vol. 283. – P. 1145–1150. DOI:10.1001/jama.283.9.1145. Anderson C. S., Huang Y., Lindley R. I. et al. Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial // Lancet Lond Engl. – 2019. – Vol. 393, № 10174. – P. 877–888. DOI:10.1016/S0140-6736(19)30038-8. Barow E., Boutitie F., Cheng B. et al. 24-hour blood pressure variability and treatment effect of intravenous alteplase in acute ischaemic stroke // Eur Stroke J. – 2021. – Vol. 6, № 2. – P. 168–175. DOI:10.1177/23969873211014758. Bath P., Chalmers J., Powers W. et al. International Society of Hypertension (ISH): statement on the management of blood pressure in acute stroke // J Hypertens. – 2003. – Vol. 21, № 4. – P. 665–672. DOI:10.1097/01.hjh.0000052489.18130.43. Berge E., Whiteley W., Audebert H. et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke // Eur Stroke J. – 2021. – Vol. 6, № 1. – P. I–LXII. DOI:10.1177/2396987321989865. Britton M., Carlsson A., de Faire U. Blood pressure course in patients with acute stroke and matched controls // Stroke. – 1986. – Vol. 17, № 5. – P. 861–864. DOI:10.1161/01.str.17.5.861. Brott T., Adams H. P., Olinger C. P. et al. Measurements of acute cerebral infarction: a clinical examination scale // Stroke. – 1989. – Vol. 20, № 7. – P. 864–870. DOI:10.1161/01.str.20.7.864. Castro P., Azevedo E., Serrador J. et al. Hemorrhagic transformation and cerebral edema in acute ischemic stroke: Link to cerebral autoregulation // J Neurol Sci. – 2017. – Vol. 372. – P. 256–261. DOI:10.1016/j.jns.2016.11.065. Chen M., Kronsteiner D., Pfaff J. et al. Hemodynamic status during endovascular stroke treatment: association of blood pressure with functional outcome // Neurocrit Care. – 2021. – Vol. 35, № 3. – P. 825–834. DOI:10.1007/s12028-021-01229-w. Dawson S. L., Panerai R. B., Potter J. F. Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke // Cerebrovasc Dis Basel Switz. – 2003. – Vol. 16, № 1. – P. 69–75. DOI:10.1159/000070118. Dawson S. L., Blake M. J., Panerai R. B. et al. Dynamic but not static cerebral autoregulation is impaired in acute ischaemic stroke // Cerebrovasc Dis Basel Switz. – 2000. – Vol. 10, № 2. – P. 126–132. DOI:10.1159/000016041. GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 // Lancet Neurol. – 2019. – Vol. 18, № 5. – P. 439–458. DOI:10.1016/S1474-4422(19)30034-1. Gąsecki D., Coca A., Cunha P. et al. Blood pressure in acute ischemic stroke: challenges in trial interpretation and clinical management: position of the ESH Working Group on Hypertension and the Brain // J Hypertens. – 2018. – Vol. 36, № 6. – P. 1212–1221. DOI:10.1097/HJH.0000000000001704. Jillella D. V., Calder C. S., Uchino K. et al. Blood pressure and hospital discharge outcomes in acute ischemic stroke patients undergoing reperfusion therapy // J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. – 2020. – Vol. 29, № 11. – P. 105211. DOI:10.1016/j.jstrokecerebrovasdis.2020.105211. Mican J., Toul M., Bednar D. et al. Structural biology and protein engineering of thrombolytics // Comput Struct Biotechnol J. – 2019. – Vol. 17. – P. 917–938. DOI:10.1016/j.csbj.2019.06.023. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke // N Engl J Med. – 1995. – Vol. 333, № 24. – P. 1581–1587. DOI:10.1056/NEJM199512143332401. Nogueira R. G., Liebeskind D. S., Sung G. et al. Predictors of good clinical outcomes, mortality, and successful revascularization in patients with acute ischemic stroke undergoing thrombectomy: pooled analysis of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI Trials // Stroke. – 2009. – Vol. 40, № 12. – P. 3777–3783. DOI:10.1161/STROKEAHA.109.561431. Rajsic S., Gothe H., Borba H. H. et al. Economic burden of stroke: a systematic review on post-stroke care // Eur J Health Econ HEPAC Health Econ Prev Care. – 2019. – Vol. 20, № 1. – P. 107–134. DOI:10.1007/s10198-018-0984-0. Romoli M., Vandelli L., Bigliardi G. et al. Fibrinogen depletion coagulopathy predicts major bleeding after thrombolysis for ischemic stroke: a multicenter study // Stroke. – 2022. – Vol. 53, № 12. – P. 3671–3678. DOI:10.1161/STROKEAHA.122.039652. Saini V., Guada L., Yavagal D. R. Global epidemiology of stroke and access to acute ischemic stroke interventions // Neurology. – 2021. – Vol. 97. – P. S6–S16. 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DOI:10.1161/01.HYP.0000105052.65787.35. https://www.vair-journal.com/jour/article/view/896 doi:10.24884/2078-5658-2023-20-6-28-34 Authors who publish with this journal agree to the following terms:Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). 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Messenger of ANESTHESIOLOGY AND RESUSCITATION; Том 20, № 6 (2023); 28-34 Вестник анестезиологии и реаниматологии; Том 20, № 6 (2023); 28-34 2541-8653 2078-5658 артериальное давление intravenous thrombolysis arterial pressure системный тромболизис info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 2023 ftjvair https://doi.org/10.24884/2078-5658-2023-20-6-28-3410.17116/jnevro2018118415-1210.1161/01.str.24.1.3510.1161/STROKEAHA.109.54860210.1001/jama.283.9.114510.1016/S0140-6736(19)30038-810.1177/2396987321101475810.1097/01.hjh.0000052489.18130.4310.1177/23969873 2023-12-19T17:50:50Z Introduction. Reperfusion (both pharmacological and interventional) is the cornerstone of acute ischemic stroke (AIS) management. Currently, there are only limited data in the scientific literature regarding the influence of systemic hemodynamic parameters on the recanalization status and complications of AIS.The objective of our study was to assess the relationship between the systemic hemodynamic parameters in the early postreperfusion period and the outcomes of AIS.Materials and methods. For retrospective analysis, data of 292 patients who received intravenous thrombolysis (IVT) at the Arkhangelsk Regional Stroke Center between 2010 and 2021 were collected. The main endpoints were functional outcome, mortality, and symptomatic intracranial hemorrhage (sICH). The success of reperfusion was defined as the neurological improvement by 4 or more points of the NIHSS score within the first 24 hours after the start of IVT.Results. The relationship between mean systolic blood pressure (SBP) during the first 24 hours of IVT and functional recovery was obtained: B = 0.016 (β = 0.096) [95 % CI 0.000 – 0.031] (р = 0.49). The relationship between maximal SBP during the first day of IVT and functional recovery was also determined: B = 0.009 (β = 0.102) [95 % CI 0.001 – 0.018] (p = 0.037). The sICH occurred in nine cases, all of them were in the group without achieving successful reperfusion.Conclusion. The baseline levels of SBP ≥ 160 mm Hg at hospital admission in patients with AIS followed by IVT are accompanied by worse functional outcome and greater odds of death. The neurological improvement with significant decline in the NIHSS score during the first 24 hours after IVT is associated with a decreased risk of sICH. Введение. Реперфузионные методики (как фармакологические, так и интервенционные) являются основой терапии ишемического инсульта (ИИ) в острейшем периоде. На текущий момент в научной литературе существуют только ограниченные данные о влиянии статуса реканализации на параметры системной гемодинамики и исходы ... Article in Journal/Newspaper Arkhangelsk Messenger of ANESTHESIOLOGY AND RESUSCITATION Food Processing: Techniques and Technology 513 524

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