Key result
Elevated pulse pressure-driven hemodynamic parameters are linked to ~92% higher odds of progressive cerebral infarction.
Why the study?
Progressive cerebral infarction causes poor prognosis after ischemic stroke, and blood pressure-indicated hemodynamic changes may play a key role in its development.
Are blood pressure-derived hemodynamic parameters and abnormal circadian rhythms associated with the development of progressive cerebral infarction in patients with acute ischemic stroke?
Observational (n=80)
No
Are blood pressure-derived hemodynamic parameters and abnormal circadian rhythms associated with the development of progressive cerebral infarction in patients with acute ischemic stroke?
Elevated baseline pulse pressure, systolic blood pressure, abnormal circadian blood pressure rhythms, and high fibrinogen levels in the acute phase of ischemic stroke are independently associated with progressive cerebral infarction.
May flag higher-risk acute ischemic stroke patients but should not change practice; leaves open need for prospective trials.
Progressive cerebral infarction (PCI) is a common complication in patients with ischemic stroke that leads to poor prognosis. Blood pressure (BP) can indicate post-stroke hemodynamic changes which play a key role in the development of PCI. The authors aim to investigate the association between BP-derived hemodynamic parameters and PCI. Clinical data and BP recordings were collected from 80 patients with cerebral infarction, including 40 patients with PCI and 40 patients with non-progressive cerebral infarction (NPCI). Hemodynamic parameters were calculated from the BP recordings of the first 7 days after admission, including systolic and diastolic BP, mean arterial pressure, and pulse pressure (PP), with the mean values of each group calculated and compared between daytime and nighttime, and between different days. Hemodynamic parameters and circadian BP rhythm patterns were compared between PCI and NPCI groups using t-test or non-parametric equivalent for continuous variables, Chi-squared test or Fisher's exact test for categorical variables, Cox proportional hazards regression analysis and binary logistic regression analysis for potential risk factors. In PCI and NPCI groups, significant decrease of daytime systolic BP appeared on the second and sixth days, respectively. Systolic BP and fibrinogen at admission, daytime systolic BP of the first day, nighttime systolic BP of the third day, PP, and the ratio of abnormal BP circadian rhythms were all higher in the PCI group. PCI and NPCI groups were significantly different in BP circadian rhythm pattern. PCI is associated with higher systolic BP, PP and more abnormal circadian rhythms of BP.
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Li et al. (2024) conducted an observational in Acute ischemic stroke (n=80). Elevated blood pressure-derived hemodynamic parameters (pulse pressure-driven) vs. Normal or lower blood pressure parameters was evaluated on Progressive cerebral infarction (PCI) (OR 1.915, 95% CI 1.099-3.336, p=0.022). Higher pulse pressure-driven hemodynamic parameters (OR 1.915) and elevated fibrinogen at admission (OR 2.268) were independently associated with the development of progressive cerebral infarction in acute ischemic stroke.
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