Abstract WMP76: Increased Systolic Blood Pressure Variability is Associated With Symptomatic Intracerebral Hemorrhage After Endovascular Treatment for Stroke
Introduction: Hemorrhagic transformation is a serious complication of endovascular treatment (IAT) for acute ischemic stroke. Increased systolic blood pressure variability (SBPV) is associated with symptomatic intracerebral hemorrhage (sICH) after intravenous rt-PA, however the association with IAT is unknown.
Hypothesis: Increased SBPV will be associated with sICH after IAT for acute ischemic stroke.
Methods: We retrospectively reviewed ischemic stroke patients from 2005-2013 who received IAT at a single center. SBPV was measured by standard deviation (SD) and coefficient of variation (CV) for all readings documented within 48 hours of hospital arrival (7,117 readings). A multivariable ordinal logistic regression model with the dichotomous outcome of sICH was used.
Results: There were 156 patients identified, 49% male, mean age 64±15 years, and mean presenting NIHSS 16±8. Only 13/156 patients were treated with second-generation retrievable stent devices. sICH was identified in 18/156 patients (11.5%). Mean blood pressure was not significant at 24 or 48 hours. After controlling for potential confounders, a one quartile increase of SBP SD or CV was associated with a 1.8 to 2.3 fold increased risk of sICH (see Table and Figure).
Conclusions: In acute ischemic stroke patients who undergo IAT, increased SBPV in the first 24 and 48 hours is associated with an approximately 80% increased risk of sICH. This association warrants prospective investigation, particularly in populations with predominant use of new generation stentrievers.
Author Disclosures: A. Bennett: None. M. Wilder: None. J. Majersik: Research Grant; Significant; NIH/NINDS U10 NS086606. S. Ansari: None. A. de Havenon: None.
- © 2016 by American Heart Association, Inc.