Key result
Early stroke pulse pressure variability is linked to ~382% higher odds of unfavorable outcomes per 10 mmHg.
Why the study?
The study aimed to determine the association between pulse pressure variability and short- and long-term outcomes in patients with acute ischemic stroke.
Does elevated pulse pressure variability during the first 72 hours after admission predict unfavorable functional outcome at 30 and 90 days in patients with acute ischemic stroke?
Cohort (n=203)
No
Does elevated pulse pressure variability during the first 72 hours after admission predict unfavorable functional outcome at 30 and 90 days in patients with acute ischemic stroke?
Effect estimate: OR 4.817 (95% CI 2.283-10.162)
p-value: p=0.000
Elevated pulse pressure variability during the first 72 hours of acute ischemic stroke is an independent predictor of unfavorable functional outcome and death at 30 and 90 days.
Pulse pressure variability in early acute ischemic stroke was associated with unfavorable outcome; hypothesis-generating for prospective trials on variability-targeted interventions.
This study aimed to determine the association between pulse pressure variability (PPV) and short- and long-term outcomes of acute ischemic stroke (AIS) patients. We studied 203 tertiary stroke center patients with AIS. PPV during 72 h after admission was analyzed using different variability parameters including standard deviation (SD). Patients' outcome was assessed after 30 and 90 days post-stroke with modified Rankin Scale. The association between PPV and outcome was investigated using logistic regression analysis with adjustment for potential confounders. The predictive significance of PPV parameters was determined using area under the curve (AUC) of receiver operating characteristics. In the unadjusted logistic regression analysis, all PPV indicators were independently associated with unfavorable outcome at 30 days (i.a. Odds ratio (OR) = 4.817, 95%CI 2.283-10.162 per 10 mmHg increase in SD, p = 0.000) and 90 days (i.a. OR = 4.248, 95%CI 2.044-8.831 per 10 mmHg increase in SD, p = 0.000). After adjustment for confounders, ORs for all PPV indicators remained statistically significant. On the basis of AUC values, all PPV parameters were found relevant outcome predictors (p < 0.01). In conclusion, elevated PPV during first 72 h after admission due to AIS is associated with unfavorable outcome at 30 and 90 days, independent of mean blood pressure levels.
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Kamieniarz-Mędrygał et al. (2023) conducted a cohort in Acute ischemic stroke (n=203). Elevated pulse pressure variability (per 10 mmHg increase in SD) vs. Lower pulse pressure variability was evaluated on Unfavorable functional outcome (mRS ≥ 3) at 30 days (OR 4.817, 95% CI 2.283-10.162, p=0.000). Every 10 mmHg increase in pulse pressure variability standard deviation during the first 72 hours of acute ischemic stroke increased the odds of unfavorable outcome at 30 days (OR 4.817).
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