Key result
Acute in-hospital blood pressure variability (e.g., SBP SD OR 1.177; 95% CI 1.021-1.356) independently predicted early neurological deterioration in acute SSSI patients with parental arterial disease.
Why the study?
Does blood pressure variability predict early neurological deterioration in patients with acute single small subcortical infarct?
Cohort (n=296)
No
Does blood pressure variability predict early neurological deterioration in patients with acute single small subcortical infarct?
Odds Ratio: 1.177 (95% CI 1.021–1.356)
Acute in-hospital blood pressure variability is associated with early neurological deterioration in patients with acute single small subcortical infarct, specifically those with parental arterial disease.
May identify higher-risk acute SSSI patients with parental arterial disease; leaves open whether BP variability is a modifiable target.
Background and purpose Early neurological deterioration (END) is not uncommon in acute single small subcortical infarct (SSSI), especially in those with parental arterial disease (PAD). The purpose of this study was to elucidate the effect of BP variability on the development of END as well as functional outcome at 90 days in SSSI and to determine whether the effect is linked to the status of parent artery. Methods Consecutive patients with acute SSSI were prospectively recruited from the First People's Hospital of Yangzhou between Aug 2013 and Jul 2016. END was defined as an NIHSS score increased ≥ 2 during the first 72 h compared with the initial NIHSS score. Functional outcome at 90 days after onset was assessed using the modified Rankin Score (mRS) and dichotomized as good (0–2) and poor (≥ 3). During this period, the parameters of BP variability such as BP max–min , BP SD , and BP CV (equal to [SD × 100] / mean) were calculated. Results A total of 296 patients were included in the analysis. Of these, 30 (38.5%) SSSI associated with PAD and 53 (24.3%) without developed END respectively. Logistic regression analysis demonstrated that SBP max (OR 1.036, 95% CI 1.005–1.069), SBP SD (OR 1.177, 95% CI 1.021–1.356), SBPcv (OR 1.306, 95% CI 1.049–1.626), DBP max (OR 1.141, 95% CI 1.042–1.250), DBP max–min (OR 1.085, 95% CI 1.015–1.160), DBP SD (OR 1.369, 95% CI 1.032–1.816), and DBP CV (OR 1.281, 95% CI 1.028–1.597) were all the independent predictors of END after acute SSSI associated with PAD. However, for those without PAD, none of the BP parameters was found significantly associated with END. Also, BP parameters were not related to the poor outcome at 90 days after onset. Conclusions Our study demonstrated that the acute in-hospital BP variability was associated with the development of END in patients with acute SSSI. However, its impact varies depending on the status of parent artery.
No takes yet. Share an insight, caveat, or question.
Duan et al. (2017) conducted a cohort in Acute single small subcortical infarct (SSSI) (n=296). Blood pressure variability was evaluated on Early neurological deterioration (END) defined as an NIHSS score increased ≥ 2 during the first 72 h (OR 1.177, 95% CI 1.021-1.356). Acute in-hospital blood pressure variability (e.g., SBP SD OR 1.177; 95% CI 1.021-1.356) independently predicted early neurological deterioration in acute SSSI patients with parental arterial disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: